Public Health Agency
of Canada
2006-07
Departmental
Performance
Report
Tony Clement
Minister of Health
Table of Contents
SECTION I – OVERVIEW . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1
Message from Canada’s Minister of Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3
Message from Canada’s Chief Public Health Officer . . . . . . . . . . . . . . . . . . . . . . . .
5
Management Representation Statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
Summary Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
The Agency’s Reason for Existence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Financial Resources 2006-07 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Human Resources (Full-Time Equivalents) 2006-07 . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Status on Performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Overall Departmental Performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Strategic Context/Operating Environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Link to the Government of Canada Outcome Areas . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Details of Performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
SECTION II – ANALYSIS BY STRATEGIC OUTCOME AND KEY PROGRAM . . . . . .
23
Analysis by Strategic Outcome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Financial Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Human Resources (Full-Time Equivalents) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Analysis by Key Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Emergency Preparedness and Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Infectious Disease Prevention and Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Health Promotion and Chronic Disease Prevention . . . . . . . . . . . . . . . . . . . . . . . . . . .
Public Health Tools and Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Strategic and Developmental Initiatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other Programs and Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
25
29
41
52
56
58
SECTION III – SUPPLEMENTARY INFORMATION . . . . . . . . . . . . . . . . . . . . . . . . . 59
Table 1:
Table 2:
Table 3:
Table 4:
Table 5:
Table 6:
Table 7A:
Table 7B:
Comparison of Planned to Actual Spending (including Full-Time Equivalents) . . . .
Resources by Program Activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Voted and Statutory Items . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Services Received Without Charge . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Sources of Respendable and Non-respendable Revenue. . . . . . . . . . . . . . . . . . .
Resource Requirements by Branch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
User Fees Act . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Policy on Service Standards for External Fees . . . . . . . . . . . . . . . . . . . . . . . . . . .
DEPARTMENTAL PERFORMANCE REPORT 2006–07
60
61
61
62
63
64
65
65
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i
Table 8:
Table 9:
Table 10:
Table 11:
Table 12:
Table 13:
Table 14:
Table 15:
Details on Transfer Payment Programs (TPPs). . . . . . . . . . . . . . . . . . . . . . . . . . .
Conditional Grants (Foundations). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Financial Statements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Response to Parliamentary Committees, and Audits and Evaluations . . . . . . . . . .
Sustainable Development Strategy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Procurement and Contracting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Horizontal Initiatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Travel Policies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
66
66
67
80
83
84
84
84
SECTION IV – OTHER ITEMS OF INTEREST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Organizational Chart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
Strategic Plan 2007-2012: Information, Knowledge, Action . . . . . . . . . . . . . . . . . . . 87
Corporate Business Planning. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
Human Resources Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88
Sustainable Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Risk Communications Framework . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Centre for Excellence in Evaluation and Program Design . . . . . . . . . . . . . . . . . . . . . 90
Economics and Social Science Services Group (ES) Development Program . . . . . . . . 90
New Program Activity Architecture for 2007-08 . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Abbreviations Used in This Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
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PUBLIC HEALTH AGENCY OF CANADA
Section I – Overview
Overview
Section I
Message from Canada’s Minister of Health
I am pleased to present the Public Health Agency of Canada’s Performance Report
for 2006-07. Health and access to a strong and effective health care system
continue to be among the highest priorities for Canadians. These priorities are
shared by Canada’s New Government, and they continue to be my paramount
concerns as Minister of Health.
I recognize the key contributions of the Agency and its deputy, the Chief Public
Health Officer, in improving public health in Canada. This is why my first piece of
federal legislation was the introduction of The Public Health Agency of Canada
Act. I was proud to see the Act approved by Parliament and entered into force in
December 2006, as it reaffirmed the Government of Canada’s commitment to
public health. The Agency enhances the federal government’s ability to plan for
and respond to public health emergencies, such as SARS or pandemic influenza;
works to reduce disease and injury; and provides ongoing leadership in
strengthening the public health infrastructure in Canada. This Performance Report
shows the significant achievements made by the Agency during 2006-07, its
second full year of operation.
Guaranteeing patient wait times remains one of our government’s highest
priorities. Reducing the burden on the health care system by improving overall
public health continues to be one of the most effective ways of achieving this goal.
Because major chronic diseases share common risk factors, Canada’s New
Government, with the support of the Public Health Agency and in collaboration
with the provinces, territories and key stakeholders, continued its work to address
health promotion and the prevention and control of chronic diseases such as
cancer, diabetes and cardiovascular disease, through a combination of integrated
and disease specific strategies and programs. Budget 2007 provided $300 million
over three years to support provinces and territories to launch human papillomavirus (HPV) vaccination programs targeting cervical cancer. For this the Agency
took the leadership role in coordinating Canada’s first collaborative planning
exercise for immunization programs.
In February 2007 the Prime Minister’s announcement of the Canadian HIV
Vaccine Initiative reflected the Agency’s contribution to worldwide efforts to
develop safe and effective HIV vaccines. The Agency’s partners in the Initiative
include Health Canada, the Canadian Institutes of Health Research, the Canadian
International Development Agency, Industry Canada, and the Bill & Melinda Gates
Foundation. Work towards HIV vaccines complements the Agency’s other HIV
initiatives such as the AIDS Community Action Program which supported 148
beneficial projects across Canada.
The Agency helped our government provide Canadians with safe and secure
communities by effectively reducing the threat of infectious diseases. In particular,
the Public Health Agency took a leadership role in updating and publishing the
updated Canadian Pandemic Influenza Plan for the Health Sector in December
2006, in collaboration with federal partners and the provinces and territories. This
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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3
Message from Canada’s Chief Public Health
Officer
The Public Health Agency of Canada exists to strengthen the Government of
Canada’s ability to protect the health and safety of Canadians, and to provide a
national focal point to lead efforts in the advancement of public health both
nationally and internationally. I am pleased to take part in this accounting to
Parliament and the Canadian public of the Agency’s work over 2006-07.
It is the role of the Chief Public Health Officer of Canada to report on matters
relating to public health and to share information and best practices with
governments, public health authorities and others in the health field, both within
Canada and internationally. It is also the Chief Public Health Officer’s
responsibility to speak to Canadians as a credible and trusted voice on public
health issues, and to advise the Minister of Health on matters of public health and
on the operations of the Public Health Agency.
Because public health is complex, success requires a comprehensive team
approach that brings in partners from across all sectors of society. The Agency
actively engages many partners, including Health Canada and the rest of the
health portfolio, other federal departments, the provinces and territories,
stakeholders, and non-governmental organizations to promote and protect the
health of Canadians.
Public health often receives its greatest attention during times of crisis, and one of
the Agency’s highest priorities is to prepare and plan for such events, including a
potential influenza pandemic. The money provided to the Public Health Agency
from the $1 billion investment in pandemic preparedness initiated in Budget 2006
enabled the Agency to increase collaboration with its partners and to take
additional steps to protect Canadians from public health emergencies. In cooperation with Public Safety Canada, the Department of Foreign Affairs and
International Trade and the Canadian Food Inspection Agency, the Public Health
Agency of Canada co-developed the North American Avian and Pandemic
Influenza Plan with the United States and Mexico which outlines how the three
countries will work together if needed. The Agency also played a key role in the
development of a proposed Federal, Provincial, and Territorial Memorandum of
Understanding on the Provision of Mutual Aid in Relation to Health Resources
during an Emergency. In addition, the Agency continued collaboratively building
an effective national emergency stockpile system of critical supplies including antiviral drugs in the event of an influenza pandemic.
Public health is about keeping people healthy, which helps to ensure a solid
foundation for a prosperous society. The Agency helps strengthen this foundation
by ensuring that we, as a society, take steps to address health disparities. During
2006-07 the Agency provided financial support for initiatives across the country
that increased community capacity to address factors affecting the health of
vulnerable groups. Also, during 2006-07 the Agency contributed to and
disseminated learnings from the World Health Organization’s Commission on
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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5
organization chart, a risk communications framework,
and the new Program Activity Architecture adopted for
2007-08.
Included throughout the report are links to the
Agency’s website and to websites of external partners
and other organizations. Readers are encouraged to
visit these sites for additional information about the
work of the Agency and our partners.
How Performance Information is Gathered and
Used at the Agency
The Agency gathers and uses both financial and nonfinancial information for operational and reporting
purposes. Financial performance information is
carefully monitored to ensure financial commitments
are met and expenditures accounted for. Performance
information is used for making operational decisions
and for communicating with stakeholders. When
appropriate, evaluations are used to generate and/or
confirm performance information; they are also used
to create or amend policies and/or procedures and to
renew or change program design.
The financial information at the heart of this report
has been generated by the Finance and Administration Directorate, using the Agency’s financial
management systems. These numbers are verified
internally, and may be validated from time to time
through external reviews and audits.
The non-financial performance information used in
this report was gathered from multiple internal
sources including the senior managers responsible for
carrying out the commitments set out in the 2006-07
Report on Plans and Priorities. These managers report
back on the actions taken and the results they have
achieved. Through the departmental performance
reporting process senior managers are held
accountable to report back on the commitments
made by the Agency for the previous year.
The Agency’s Reason for Existence
Canadians are among the healthiest people in the
world. Two factors which contribute to Canadians’
8 |
PUBLIC HEALTH AGENCY OF CANADA
high quality of life are their access to a modern and
sustainable publicly-funded health care system and
the existence of a strong public health system. The
actions of the public health community are often not
as apparent as those in the conventional health care
system, because public health targets the entire
population, working upstream to avoid potential
problems and to deal with them as they occur. Public
Health works to identify threats and risks to the health
of Canadians at large, as opposed to health care,
which focuses on individuals. While they are both part
of the continuum of health, the emphasis in public
health is prevention. By helping keep Canadians
healthy, the Agency, in partnership with the public
health community, not only improves health and
quality of life, but can also relieve some of the
pressure on the health care system, helping to
constrain costs and lessen patient wait times.
Public health involves a range of players and partners
engaging in initiatives that promote health, prevent
and control both infectious and chronic diseases,
support public health research and surveillance
activities, and protect people from the consequences
of health emergencies. In Canada, public health is a
responsibility shared by the three levels of government, the private sector, the not-for-profit sector and
health professionals such as family physicians. The
Agency works closely with other federal departments
and agencies, provinces and territories, and other
stakeholders to keep Canadians healthy.
Events like the emergence of severe acute respiratory
syndrome (SARS) in 2003 demonstrated the need for
Canada to have a national point of focus for public
health issues. In response, the Public Health Agency
of Canada was established on September 24, 2004,
and Dr. David Butler-Jones was appointed as the
country’s first Chief Public Health Officer (CPHO).
The creation of the Agency marked the beginning of
a new approach to federal leadership, and to
collaboration with the provinces and territories in the
Government’s efforts to renew the public health
system in Canada. On December 15, 2006, the
Public Health Agency of Canada Act came into force,
providing a statutory basis for the Agency. The Act
formally establishes the position of the Chief Public
Health Officer and recognizes his unique dual role as
deputy head of the Agency and as Canada’s lead
public health professional:
As the deputy head of the Agency, the CPHO is
accountable to the Minister of Health for the daily
operations of the Agency, and advises the Minister on
public health matters. The CPHO can engage other
federal departments and mobilize the resources of the
Agency to meet threats to the health of Canadians.
The CPHO is also Canada’s lead public health
professional, with demonstrated expertise and
leadership in this field. For this reason, the CPHO has
the legislated authority to communicate directly with
Canadians and to prepare and publish reports on any
public health issue. He is also required to submit to
the Minister of Health, for tabling in Parliament, an
annual report on the state of public health in Canada.
By providing the CPHO with authority to speak out on
public health matters and ensuring that he or she has
strong qualifications in the field of public health, the
Public Health Agency of Canada Act protects the
CPHO’s credibility.
The role of the Agency can be summed up as follows:
n To take a lead role in the prevention of disease
and injury and the promotion of health;
n To provide a clear focal point for federal
leadership and accountability in managing public
health emergencies;
n To serve as a central point for sharing Canada’s
expertise with the rest of the world and applying
international research and development to
Canada’s public health programs; and
n To strengthen intergovernmental collaboration on
public health and facilitate national approaches to
public health policy and planning.
The Agency is mandated to work in collaboration with
its partners to lead federal efforts and to mobilize
pan-Canadian action in preventing disease and
injury, and to promote and protect national and
international public health by:
n Anticipating, preparing for, responding to and
recovering from threats to public health;
n Carrying out surveillance of, monitoring,
researching, investigating and reporting on
diseases, injuries, other preventable health risks
and their determinants, and the general state of
public health in Canada and internationally;
n Using the best available evidence and tools to
advise and support public health stakeholders
nationally and internationally as they work to
enhance the health of their communities;
n Providing public health information, advice and
leadership to Canadians and stakeholders; and
n Building and sustaining a public health network
with stakeholders.
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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9
The Agency at a Glance
Type of Organization
Federal Agency, funded by Parliament
Mission
To promote and protect the health of Canadians through leadership,
partnership, innovation and action in public health
Vision
Healthy Canadians and communities in a healthier world
Strategic Outcome for
Reporting Period
Healthier Population by Promoting Health and Preventing Disease and
Injury
Strategic Outcome for
2007-08
Healthier Canadians and a stronger public health capacity
Government of Canada
Outcome Directly Supported
Healthy Canadians
Enabling Legislation
Public Health Agency of Canada Act
Acts and Regulations
Administered
The Quarantine Act
Key Activities
n Health Promotion
The Importation of Human Pathogen Regulations
n Chronic Disease Prevention and Control
n Infectious Disease Prevention and Control
n Emergency Preparedness and Response
n Strengthening Public Health Capacity
Reporting to Parliament
10 |
The Agency reports to Parliament through the Minister of Health
PUBLIC HEALTH AGENCY OF CANADA
The Agency’s Structure
The following organization chart depicts how the Agency is structured within the Federal Health Portfolio.
Minister of Health
Public Health Agency of Canada
Chief Public Health Officer
Health Canada
Senior Science Advisor
Chief Financial Officer (CFO)
Chief Audit Executive (CAE)
Hazardous Material
Information
Review Commission
Senior Assistant Deputy Minister
Planning and Public Health Integration
Assistant Deputy Minister
Infectious Disease and
Emergency Preparedness
Canadian Institutes
of Health Research
Deputy Chief Public Health Officer
Deputy Chief Public Health Officer
Health Promotion and Chronic Disease Prevention
Public Health Practice
Patented Medicine
Prices Review Board
Executive Director
Director General
Corporate Secretariat
Strategic Policy
Director General
Director General
Human Resources
Communications
Director General
Director General
Information Management/
Information Technology
Assisted Human
Reproduction Agency
of Canada
Regional Operations
Director General
Administrative Services
(including Accommodation,
Safety, Security, etc.)
The Agency’s Operations Across Canada
To maintain the knowledge and skills needed to
develop and deliver the public health advice and tools
required by Canadians, the Agency calls upon the
efforts of public health professionals, scientists,
technicians, communicators, administrators, and
policy analysts and planners. These employees work
across Canada in a wide range of operational,
scientific, technical and administrative positions.
The largest concentration of employees is in the
National Capital Region. The head office in Winnipeg
forms a second pillar of expertise. In times of a
national health emergency, the Emergency
Operations Centre based in both in Ottawa and
Winnipeg can be utilized to manage the crisis.
The Public Health Agency of Canada recognizes the
need to have a strong presence throughout the
country to connect with provincial and territorial governments, federal departments, academia, voluntary
organizations and citizens. Outside of Winnipeg and
the National Capital Region, the Agency’s Canadawide infrastructure consists of 16 locations in six
Regions: British Columbia & Yukon, Alberta & Northwest Territories, Manitoba & Saskatchewan, Ontario
& Nunavut, Quebec, and Atlantic. Some Agency
programs are delivered to the Yukon, Nunavut and
the Northwest Territories through Health Canada’s
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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11
Northern Region office under an interdepartmental
agreement. The Agency’s Regional Offices promote
integrated action on public health throughout the
country. Working in partnerships that cross sectors and
jurisdictions, staff in these offices facilitate collaboration on national priorities, building on resources at
the regional, provincial and district levels.
The Agency operates specialized research
laboratories in several locations across Canada. The
Canadian Science Centre for Human and Animal
Health in Winnipeg houses the Agency’s state-of-the-
Collaboration and Partnership
Most public health activities, including those
performed by the Agency, involve collaboration and
partnership with the provinces and territories, other
federal departments, health organizations,
professional organizations, academia, the private and
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PUBLIC HEALTH AGENCY OF CANADA
art National Microbiology Laboratory which is one of
the world’s high containment research laboratories.
The Agency’s Laboratory for Foodborne Zoonoses,
which studies the risks to human health from diseases
arising from the interface between animals, humans
and the environment, is headquartered in Guelph,
Ontario and maintains units in St. Hyacinthe, Quebec
and Lethbridge, Alberta.
The following map shows where the Agency’s staff,
offices and laboratories are located (employee
numbers are as of March 31, 2007):
not-for-profit sectors and/or other stakeholders. This
creates challenges for performance measurement, as
positive health outcomes and trends usually reflect the
success of joint efforts by multiple partners.
The Government of Canada’s Health Portfolio
consists of approximately 11,700 employees and an
annual budget of $4.6 billion. The Agency works
closely with the other members of the Health Portfolio,
as well as other federal departments and agencies
whose work has an impact on public health. Key
federal departments and agencies that the Agency
works with include:
The Government of Canada’s Health
Portfolio
Other Government of Canada Partners
n Assisted Human Reproduction Agency of
Canada
n Canada Border Services Agency
n Agriculture Canada;
n Canadian Food Inspection Agency
n Canadian Institutes of Health Research
n Canadian Heritage – Sport Canada
n Hazardous Materials Information Review
Commission
n Environment Canada
n Infrastructure Canada
n Health Canada
n Public Safety Canada
n Patented Medicine Prices Review Board
n Statistics Canada
n Public Health Agency of Canada
n Transport Canada
For more information see:
n www.hc-sc.gc.ca/ahc-asc/minist/healthsante/portfolio/index_e.html
Financial Resources 2006-07
Planned Spending
Total Authorities
Actual Spending
$629.7 million
$536.2 million*
$510.8 million**
** The $93.5 million difference between planned spending and authorities is mainly due to the deferment of $44 million in
funding for Avian and Pandemic Influenza Preparedness to subsequent fiscal years, and expected funding of $51 million
for Canadian Strategy for Cancer Control not flowing through the Agency.
** Actual spending was $25.4 million lower than total authorities primarily due to capacity and technical constraints which
impeded the full utilization of approved resources. Of the 25.4 million, operating expenditure accounted for $20.5 million
and transfer payments $4.9 million.
Human Resources (Full-Time Equivalents*) 2006-07
Planned
Actual
Difference
2,119
2,050
69
* To properly include persons employed for part of the year and/or employed part time in a measure showing average
employment over the year, ‘full-time equivalent’ is calculated based on days worked. The Agency began the fiscal year with
approximately 1,968 employees and ended it with approximately 2,157.
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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13
Status on Performance
The following table provides a “report card” of progress on each priority for 2006-07, and shows the financial
resources planned and spent.
Performance and spending by priority 2006-07
Strategic Outcome: Healthier Population by Promoting Health and Preventing Disease and Injury
Program Activity: Population and Public Health
Performance
Status
Planned
Spending
($ millions)
Actual Spending
($ millions)
Priority
Expected Results
#1:
Develop, enhance and
implement integrated and
disease-specific strategies and
programs for the prevention
and control of infectious
disease (ongoing)
Enhanced strategies
and programs for
the prevention and
control of infectious
disease
Successfully
met
169.6
#2:
Develop, enhance and
implement integrated and
disease – or condition-specific
strategies and programs within
the health portfolio to
promote health and prevent
and control chronic disease
and injury (ongoing)
Enhanced strategies
and programs for to
promote health and
prevent and control
chronic disease and
injury
Successfully
met
179.9
#3 :
Increase Canada’s
preparedness for and ability to
respond to public health
emergencies, including
pandemic influenza (ongoing)
Increased
preparedness for
and ability to
respond to public
health emergencies,
including pandemic
influenza
Successfully
met
55.9
55.1
#4:
Strengthen public health within
Canada and internationally by
facilitating public health
collaboration and enhancing
public health capacity
(ongoing)
Stronger public
health capacity
Successfully
met
83.8
84.0
#5:
Lead several government-wide
efforts to advance action on
the determinants of health
(new)
Advanced action on
the determinants of
health
Successfully
met
70.6
51.2 **
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PUBLIC HEALTH AGENCY OF CANADA
124.2*
* Actual spending was
$45.4 million less than plan
primarily due to deferment of
$44.1 million Avian and
Pandemic Influenza
Preparedness funding to
subsequent fiscal years.
127.4 *
* Actual spending was
$52.5 million less than
planned mainly due to
expected funding of
$51 million for Canadian
Strategy for Cancer Control
not flowing through the
Agency.
Performance and spending by priority 2006-07 (continued)
Priority
#6:
Develop and enhance the
Agency’s internal capacity to
meet its mandate (previously
committed)
Expected Results
Increased Agency
internal capacity and
ability to meet
mandate.
Performance
Status
Successfully
met
Planned
Spending
($ millions)
56.0
Actual Spending
($ millions)
68.9*
* Actual spending exceeded
plan by $12.9 million due
primarily to use of $11.0
million to address IM/IT
infrastructure requirements,
comply with mandatory
government-wide IT security
policy, and respond to a
computer malware infection.
** Actual Priority 5 spending was less than plan by $19.4 million. Of this approximately $14.1 million was due to constraints
in accommodations, staffing, and contracting which impeded reaching budgeted staff and operating levels. Also, the
Agency’s regional organization was unable to use $2.3 million as planned for supporting demonstration projects.
Additionally $1.0 million in resources earmarked for launch of ParticipACTION could not be utilized for this purpose. Of
funds earmarked to cover the costs of employee benefits for staff allocated to Priority 5, $1.1 million was not used due to
favourable rates.
Note: The Agency’s total planned spending of $629.7 million included $13.9 million not allocated to the six priorities. The
main unallocated item was $10.4 million for Hepatitis C, as the program was sunsetting. The program was subsequently
extended, and has been allocated to the ‘actual spending’ for the priorities, as has all other Agency spending for 2007-08.
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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15
Overall Departmental Performance
Strategic Context/Operating
Environment
he expanding global economy, the convergence
of people in large urban areas and the ease with
which people and goods travel around the world are
but some of the factors challenging Canada’s public
health system.
T
External factors which influenced the Agency’s activities during 2006-07 included the emergence of
infectious diseases, such as avian influenza and other
potential pandemics, both nationally and internationally; natural disasters; Canada’s gradually aging
population; social trends affecting the risk of chronic
diseases; the changing nature of our environment;
and the continued rapid evolution of science and
technology.
Infectious Disease Levels and Trends
The number of Canadians dying from or living with
infectious diseases has been climbing since the 1980s.
Worldwide, infectious diseases are the second leading
cause of death and the leading killer of infants and
children. The World Health Organization (WHO)
estimates that in 2002, the most recent year for which
statistics are available, approximately 11 million of
the 57 million deaths that occurred worldwide were
caused by infectious and parasitic diseases. While the
impact of this phenomenon is being felt most
profoundly in developing countries, Canada has not
been immune. The increase in the speed and volume
of global travel places Canadians within 24 hours of
almost any other place in the world – which is less
than the incubation period for most communicable
diseases transported by individuals or products. The
threat of emerging and re-emerging infectious
diseases and the potential for bioterrorism has made
the ability to rapidly identify infectious agents and
clusters of disease vitally important.
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PUBLIC HEALTH AGENCY OF CANADA
Risks of Avian and Pandemic Influenza
There were two major infectious disease threats that
Canada faced in 2006-07. Each could have had a
significant impact on Canada’s economic and social
stability as well as on collective and individual health
and safety. The first was the potential for the highly
contagious and deadly H5N1 (Asian) sub-type of
avian influenza to spread to domestic birds in
Canada. The second was the growing potential for
the appearance of a new strain of this (or another)
virus that has adapted to humans, resulting in humanto-human transmission and the possible setting off of
a human influenza pandemic. According to WHO,
the occurrence of the next pandemic influenza is “a
question of when, not if.”
The H5N1 (Asian) avian influenza virus has demonstrated the ability to infect and cause fatal illness in
humans. During the period from December 2003 to
April 2007, 291 human cases, resulting in 172
deaths, were laboratory-confirmed in 12 countries.
Natural Disasters
Natural disasters such as the Asian Tsunami and
Hurricane Katrina vividly underscore the importance
of emergency preparedness and capacity building in
order to enable the quick and effective responses
necessary to minimize suffering and loss. Recent
natural disasters have provided many lessons and
highlighted the need for integrated and coordinated
emergency management and effective emergency
communications at all levels of government, among
federal departments and agencies, and with other
stakeholders including individual citizens.
Demographics
Changing demographics are an important factor in
Canada. While Canada has the highest rate of
population growth among the ‘G8’ (group of eight
economically leading countries), the majority of this
comes from immigration. Due to a combination of
low birth rates and longer life spans, there is an
upward trend in the proportion of seniors in the
Canadian population. It is projected that by 2016,
those 65 years of age and older will represent
approximately 16% of the country’s population. This
change will have an impact on the incidence and
distribution of many diseases, and is likely to place
increasing pressures on health services in Canada.
Risk Factors for Chronic Disease
Changes in Canadian society have resulted in shifts
in nutrition patterns and in living and working conditions. These changes are key factors in the development of the leading chronic diseases in Canada. They
have the potential to trigger significant increases in
these diseases at substantial cost to the country’s
economy and society. Unhealthy eating, lack of physical activity and obesity continue to be critical public
health issues that have a significant bearing on health
outcomes for Canadians and the health care system.
already stressed health system. By providing new
approaches for improving health and preventing
disease, advances in public health can help mitigate
these costs. For example, there have been rapid
advances in public health genomics – an emerging
field that assesses the impact of the interaction
between genes and the environment (i.e., physical
environment, diet, behaviour, drugs, and agents of
infectious diseases) on population health. There is a
potential that the knowledge from advances in biotechnology and genome-based research can be
applied to prevent disease and improve the health of
populations.
Link to the Government of Canada
Outcome Areas
The Agency’s focus on public health allows it to
contribute directly to a key Government of Canada
Outcome: Healthy Canadians
The Agency’s work also supports achievement of
other Government of Canada outcomes, including:
Environment
Canadians are increasingly recognizing the linkages
between health and the environment, not only in
areas like the effects of toxins and pollutants, but also
in the impacts of climate change and the trade-offs
involved in sustainable development. Growing populations are placing an increased pressure on the
environment globally while, in Canada, greater
urbanization brings with it increased demands for
energy, land and other resources, as well as increased
concentrations of toxins and pollutants. A strong and
comprehensive public health policy is needed to
identify and address linkages between health and the
environment and to assist affected communities.
Rapid Evolution of Science and Technology
The rate of scientific discovery and technological
innovation has increased dramatically in the past
decade, but the impact on the health sector has been
mixed. On the one hand, advances in treatment and
care offer new opportunities to address illness and
improve health. On the other hand, these advances
have placed increased cost pressures on Canada’s
Safe and secure communities – The Agency plays
an important role in reducing the threat of infectious
diseases and chemical and biological agents, and
accordingly contributes to the safety of Canadian
communities;
A safe and secure world through international
cooperation – The Agency is committed to strengthening global health security in collaboration with its
international partners. To support Canada’s participation in the Global Health Security Initiative, the
Agency advances pandemic influenza preparedness,
moves forward to prepare against chemical and
biological threats, and leads the Global Health
Security Action Group Laboratory Network. The
Agency’s efforts contribute to Canada’s effective
participation in the Security and Prosperity Partnership
of North America;
An innovative and knowledge-based economy –
The Agency, in its own laboratories and working with
partners, conducts and provides financial support for
applied research on health technologies. For
example, it facilitates the translation of research to
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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develop and test newer, faster, and more productive
technologies that can deliver safe and effective
vaccine products to Canadians and thus advance
broader socio-economic interests. This leading-edge
work has the potential to generate ‘spin off’ economic
development while it significantly boosts public
confidence in Canada’s ability to deal with emerging
health threats.
(For more information about Government of Canada
Outcomes see http://www.tbs-sct.gc.ca/report/
govrev/06/cp-rc_e.asp).
Details of Performance
The following section provides an explanation of the
progress summarized in the ‘report card’ above. It
identifies each commitment, indicates whether the
Agency successfully met, partially met, or exceeded
expectations, and then elaborates on what was
accomplished.
1 Develop, enhance and implement integrated
and disease-specific strategies and programs
for the prevention and control of infectious
disease – Successfully met
In 2006-07 the Agency delivered a number of key
initiatives in collaboration with its partners and
stakeholders. It reviewed, revised, and expanded
the scope of its widely used Infection Control
Guidelines Series; published the Canadian
National Report on Immunization; provided
surveillance for diseases including Lyme disease,
West Nile virus and health-care acquired
infections; collaborated with provinces and
territories as well as internationally on issues
related to immunization and vaccine-preventable
infectious diseases; took the leadership role in
coordinating Canada’s first collaborative
immunization program planning exercise,
focussing on a vaccine for the human papillomavirus; and helped to organize the Canadian
Immunization Conference. The Agency’s streetyouth surveillance pilot project, undertaken in
collaboration with external stakeholders, has led to
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PUBLIC HEALTH AGENCY OF CANADA
the development of more effective mechanisms to
reach street youth and provide testing and care for
HIV, sexually transmitted infections and related
infections.
Through this and other work the Agency developed
proposals to achieve a more integrated and
coordinated approach to managing infectious
disease and improving the health status of those
who become infected. This included developing,
enhancing and implementing integrated and
disease-specific strategies and programs. Overall,
the Agency was successful in strengthening multisectoral, multijurisdictional, and multidisciplinary
approaches to infectious disease prevention.
2 Develop, enhance and implement integrated
and disease- or condition-specific strategies
and programs within the health portfolio to
promote health and prevent and control
chronic disease and injury – Successfully met
In 2006-07, the Agency worked closely with its
partners and stakeholders to implement components of the Healthy Living and Chronic Disease
initiative. This included:
n launching the Canadian Best Practices Portal
for Health Promotion and Chronic Disease
Prevention, an on-line tool which disseminates information and monitors adoption of
best practices in chronic disease prevention;
n supporting the launch of development of the
Canadian Heart Health Strategy and Action
Plan, and establishment of an Expert Advisory
Committee on Hypertension;
n establishing a steering committee to help
develop a national lung health framework
with stakeholders;
n identifying shared priorities in chronic disease
surveillance, with a focus on an enhanced
mental illness surveillance system, and
expansion of the National Diabetes
Surveillance System to other chronic
diseases; and
n Establishing new directions for the renewed
Canadian Diabetes Strategy, with a focus on
high-risk populations and earlier detection.
Additionally, the Agency was a key stakeholder in the
development of the Canadian Strategy for Cancer
Control (CSCC) by supporting and facilitating the
transition of responsibility for the implementation of
the CSCC to the new Canadian Partnership Against
Cancer, an arms length, not-for-profit entity.
3 Increase Canada’s preparedness for and
ability to respond to public health emergencies,
including pandemic influenza – Successfully met
The Agency continued to take an all-hazards
approach encompassing emergency medical
response to infectious disease outbreaks, natural
disasters, explosions or chemical, biological or
radiological/nuclear incidents in 2006-07. As a
member of the Global Health Security Initiative, the
Agency supported an effective national emergency
management system and advanced work, globally
and within Canada, on infectious disease
outbreaks and pandemic influenza preparedness.
To increase Canada’s preparedness for and ability
to respond to public health emergencies, including
pandemic influenza, the Agency engaged in
extensive emergency preparedness and response
planning with provincial and territorial governments,
other federal departments and agencies, and nongovernmental organizations to identify emerging
priorities, establish work plans and coordinate
activities. Work was done to put in place arrangements with provincial and territorial governments
to facilitate mutual assistance and information
exchanges during public health emergencies. The
Agency played a key role in the development of the
Federal, Provincial, and Territorial Memorandum
of Understanding on the Provision of Mutual Aid in
Relation to Health Resources during an Emergency,
which was received by the Conference of Deputy
Ministers of Health.
The Agency, in co-operation with Public Safety
Canada, the Department of Foreign Affairs and
International Trade and the Canadian Food
Inspection Agency, the Public Health Agency of
Canada co-developed the North American Avian
and Pandemic Influenza Plan with the United States
and Mexico to 1) detect, contain and control an
avian influenza outbreak and prevent transmission
to humans; 2) prevent or slow the entry of a novel
strain of human influenza to North America;
3) coordinate emergency management and communications; 4) minimize unwarranted disruptions
to the flow of people, goods and services at the
borders and 5) sustain critical infrastructure.
Guided by the Council of the Pan-Canadian Public
Health Network (PHN), the Agency led robust
citizen and stakeholder dialogues as one part of
a multi-faceted decision making process in the
development of a national policy recommendation
on the use of antivirals for prevention during an
influenza pandemic.
Also, the Agency continued to build an effective
stockpile of critical supplies including anti-viral
drugs in order to respond to a pandemic and other
public health emergencies.
4 Strengthen public health within Canada and
internationally by facilitating public health
collaboration and enhancing public health
capacity – Successfully met
In 2006-07 the Agency built on initial successes
such as the establishment of the Pan-Canadian
Public Health Network. For example, the Agency
provided secretariat, policy, technical, and financial support to the Network’s following groups:
n Public Health Network Council
n Council of Chief Medical Officers of Health
n Population Health Promotion Expert Group
n Surveillance and Information Expert Group
n Emergency Preparedness and Response
Expert Group
n Communicable Disease Control Expert
Group
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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n Chronic Disease and Injury Prevention and
Control Expert Group
n Canadian Public Health Laboratories Expert
Group
The Agency also continued to work closely and
cooperatively with all of its partners toward a
seamless and comprehensive pan-Canadian public
health system by addressing cross-jurisdictional
human resources capacity, collaborative information systems and tools, knowledge dissemination,
and the public health law and policy system.
Further, through partnerships and initiatives at the
local, regional, national and international levels,
and with the help of the National Collaborating
Centres for Public Health, the Agency supported
public health professionals and stakeholders in
their efforts to keep pace with rapidly evolving
conditions, knowledge and practices.
5 Lead several government-wide efforts to
advance action on the determinants of
health – Successfully met
During the fiscal year, the Agency, while recognizing the many influences that lie within the purview
of other departments, jurisdictions and sectors,
continued to strengthen its partnerships to help
address the factors that lead to disparities in health
status. In the process the Agency advocated for
healthy public policy and led efforts to advance
action on the determinants-of-health approach to
health policy. In particular, the Agency contributed
to and helped disseminate learnings from the
WHO Commission on Social Determinants of
Health through its partnerships with other countries
and through its leadership of the Canadian
Reference Group (CRG), a partnership involving
federal departments, provinces, non-governmental
organizations and academia. The CRG held dialogue sessions with non-governmental organizations to determine common agendas. It also
organized numerous presentations and dialogues
on the social determinants of health. Further, the
Agency held an exploratory meeting with leading
health economists from across Canada to consider
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PUBLIC HEALTH AGENCY OF CANADA
the feasibility of developing an economic case for
investment in the determinants of health.
The Agency’s funding programs used grants and
contributions to support initiatives across the
country to increase community capacity and
promote intersectoral action on the determinants
of health. In the Atlantic Region, the Population
Health Fund supported projects which built
community capacity to promote healthy public
policies, particularly as they affect inequity and
chronic disease. In Quebec, this Fund supported
projects to promote healthy, sustainable communities and to address the links between environment and health. The Manitoba/Saskatchewan
Region used the Population Health Fund to support
projects that address issues such as food security
and healthy aging, with a focus on aboriginal
populations. Further, programs like the Diabetes
Prevention and Promotion Contribution Program,
the AIDS Community Action Program and the
Hepatitis C Prevention, Support and Research
Program also fund projects which consider linkages
between health determinants, risk behaviour and
disease incidence and support approaches which
address the root causes of these conditions.
6 Develop and enhance the Agency’s internal
capacity to meet its mandate – Successfully met
The Agency developed and enhanced its internal
capacity. This included reviewing its Program
Activity Architecture, developing risk mitigation and
management strategies, and initiating strategic and
business planning processes that addressed
capacity issues including expansion of laboratories
as well as further development of the Winnipeg
headquarters and the Agency’s regional offices.
During 2006-07 the Agency had a single strategic
outcome and a single program activity. Work done
during the year including updating the strategic
outcome and creating an enhanced Program
Activity Architecture for fiscal year 2007-08, to
better reflect the Agency’s responsibilities and to
enable a more detailed reporting on
accomplishments and resource use.
The Strategic Risk Communications Framework
and Handbook was launched, a new and unique
tool designed to enable the Agency to integrate
strategic risk communications into effective risk
management, using a science-based process to
support effective decision-making. The tools and
techniques better enable the Agency to plan and
conduct effective risk communications as an
integral component of good decision-making with
stakeholders and ultimately the Canadian public.
An Agency Corporate Risk Assessment and Profile
was developed during 2006-07 with extensive
participation from management at all levels, and
elements of an integrated risk management
strategy were put in place. For example, Senior
Management met on a regular basis to review risk
areas and take action, when needed, to mitigate
risk. The Agency’s planning was informed by risk,
and risk mitigation processes were implemented in
a number of Agency programs. The Agency has
committed to further develop and operationalize
the corporate risk profile as the first step in
incorporating an integrated risk-management
framework into the Agency’s daily operational
practices.
During 2006-07 the Agency embarked on its first
ever strategic planning process, to set the broad
directions and establish the priorities to guide
Agency efforts over the next five years. The
Agency’s Strategic Plan will become the core of an
integrated approach to planning, providing a
policy overlay to ensure that annual business plans
are well-integrated, resources are aligned
accordingly, and the entire effort is supported by
clear accountabilities. The strategic plan is
available at http://www.phac-aspc.gc.ca/.
In 2006-07, the Agency made progress with its
initial Corporate Business Plan. The Agency’s
program and support areas identified their
objectives, challenges, and strategies in developing
the Agency’s initial business plan, and laid the
foundation for an effective annual business
planning process.
Other notable internal capacity development
achievements by the Agency during 2006-07:
n The Agency created and staffed the position
of Chief Audit Officer, to ensure that the
public’s money was well-utilized and that
good systems of checks and balances were in
place.
n An Evaluation Advisory Committee was
established, and development work
commenced for a five year risk-based
evaluation plan.
n The Agency’s Sustainable Development
Strategy was tabled and approved during the
year. It contributes to a framework for results
by setting out initial goals, objectives, targets
and performance indicators. The Strategy
also includes an internal accountability
framework showing how the Agency will
plan, monitor, evaluate and report on the
results.
n As programs and administrative processes
and organizations matured, the number of
employees expanded from 1,968 on March
31, 2006 to 2,157 one year later – growth
of 9.6%.
n The Agency made further progress in
establishing its own infrastructure to deliver
human resources services from within the
Agency with less recourse to external service
providers. As a result, corporate human
resources policies, labour relations, and
human resources planning became the sole
responsibility of the Agency and were
managed independently of Health Canada.
This allowed better alignment of these
services with the Agency’s mandate and
corporate goals.
Further information on the Agency’s Strategic Plan,
Program Activity Architecture, and other internal
capacity building initiatives is available in Section IV
of this document.
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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PUBLIC HEALTH AGENCY OF CANADA
SECTION II – ANALYSIS BY STRATEGIC OUTCOME AND KEY PROGRAM
Analysis by Strategic Outcome
and Key Program
Section II
Analysis by Strategic Outcome
Strategic Outcome:
A Healthier Population by Promoting Health and Preventing Disease and Injury
Program Activity Name:
Population and Public Health
Financial Resources
Planned Spending
Total Authorities
Actual Spending
$629.7 million
$536.2 million*
$510.8 million**
** The $93.5 million difference between planned spending and authorities is mainly due to the deferment of $44 million in
funding for Avian and Pandemic Influenza Preparedness to subsequent fiscal years, and expected funding of $51 million
for Canadian Strategy for Cancer Control not flowing through the Agency.
** Actual spending was $25.4 million lower than total authorities primarily due to capacity and technical constraints which
impeded the full utilization of approved resources. Of the $25.4 million figure, operating expenditure totalled $20.5 million
and transfer payments totalled $4.9 million.
Human Resources (Full-Time Equivalents*)
Planned
Actual
Difference
2,119
2,050
69
* To properly include persons employed for part of the year and/or employed part time in a measure showing average
employment over the year, ‘full-time equivalent’ is calculated based on days worked. The Agency began the fiscal year with
approximately 1,968 employees and ended it with approximately 2,157.
In collaboration with partners, the Agency leads federal efforts and mobilizes pan-Canadian actions to
promote and protect national and international public
health. These actions include anticipating, preparing
for, responding to and recovering from threats to
public health; and monitoring, researching and
reporting on diseases, injuries, other preventable
health risks and their determinants, and the general
state of public health in Canada and internationally.
These activities are designed to support effective
disease prevention and health promotion, and
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PUBLIC HEALTH AGENCY OF CANADA
building and sustaining a public health network with
stakeholders. The Agency uses the best available
knowledge and evidence to inform and engage
Canadian and international public health
stakeholders on various aspects of public health
activities and to provide public health information,
advice and leadership.
This Program Activity supports all six Priorities in the
2006-07 Report on Plans and Priorities.
Analysis by Key Program
Emergency Preparedness and Response
agents. Major preparedness challenges include
planning to effectively deal with all possible hazards,
providing training to health responders, coordinating
among all levels of government, and holding
sufficient emergency supplies across the country.
Canada must be prepared to respond to the public
health risks posed by all natural and human-caused
disasters, such as infectious disease outbreaks,
natural disasters and criminal or terrorist acts such as
explosions and the release of toxins or biological
Emergency Preparedness Capacity
Planned ($M)
Authorities ($M)
Actual ($M)
13.9
13.7
12.9*
* Actual spending was $0.8 million lower than authorities due to capacity and technical constraints.
WHAT WAS PLANNED
In 2006-07, the Agency planned to:
n Provide accurate and timely information on national
and global public health events to Canadian and
World Health Organization (WHO) officials through
the Global Public Health Intelligence Network;
n Develop regulations, policies, procedures and
training for the updated Quarantine Act; and
n Support and strengthen its nationwide quarantine
service.
WHAT WAS ACHIEVED
The Agency completed these plans, other than
developing regulations for the updated Quarantine
act, with some achievements going beyond
expectations.
The Global Public Health Intelligence Network
(GPHIN) anticipates and tracks infectious disease outbreaks using software which monitors large volumes
of worldwide news reports. During 2006-07 GPHIN
added the capability of monitoring in Portuguese, and
provided a team of analysts to cover the evening and
night shift to provide 24/7 analytical coverage to
meet the needs of stakeholders such as WHO and
other users worldwide for accurate and timely
information.
Using GPHIN, the Agency provided support to mass
gathering events by monitoring for potential public
health threats during the entire event. GPHIN worked
closely with the Caribbean Epidemiology Centre
(CAREC) to provide support during the Cricket World
Cup games held in Trinidad and Tobago and its
neighbouring Caribbean countries in March 2007.
A new Quarantine Act came into force on December
12th, 2006. It replaced the existing Quarantine Act
and Quarantine Regulations with new and modern
authorities to better protect Canadians from the
introduction and spread of foreign communicable
diseases. The Agency developed necessary implementation tools, which included: training key federal
officials including Quarantine and Environmental
Health Officers; developing standard operating
procedures; and educating federal, provincial, and
territorial partners on the new legislation.
The Quarantine Act contains authority to make
regulations on a variety of topics. Work began on the
assessment of needs so that the Agency will be able to
develop regulations in accordance with their priority.
The development of a National Marine Quarantine
Protocol was undertaken to strengthen the delivery of
quarantine services to marine ports. This Agency-led
initiative provided guidance for departments and
agencies with responsibilities related to quarantine
issues at sea and in Canadian ports.
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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The Agency delayed development of new regulations
for the new Quarantine Act owing to a major policy
issue that was eventually resolved through Bill C42,
but was otherwise able to complete all other plans,
with some achievements going beyond expectations.
Development of new regulations was rescheduled.
Working collaboratively with partners and stakeholders under the Treasury Board’s Public Safety and
Anti-Terrorism Initiative , the Agency developed and
delivered Chemical, Biological, Radiological and
Nuclear (CBRN) training courses such as Tier 1
Laboratory Bioterrorism Recognition and the fivepartner CBRN First Responder training led by Public
Safety Canada. Additionally, the Agency coordinated
development and pilot implementation of Emergency
Social Services, Emergency Health Services, and
Disaster Behavioural Health for Health Care Professionals courses. The Agency will be putting both new
and existing programs on-line in order to facilitate
effective delivery of the courses for Canadians who
require or desire this training.
The 2006 National Forum on Emergency Preparedness and Response, held in Vancouver in December,
brought more than 250 emergency management
stakeholders from around Canada to address the
issue of building more disaster-resilient communities
in Canada. This has laid the foundation for the
development of a more comprehensive vulnerability/
resiliency framework to reduce the risks of emergencies to Canadians. The Agency and PSC co-hosted
and funded the forum.
The Agency developed and conducted the first of a
series of monthly tabletop exercises to more clearly
define processes, operating concepts and procedures,
and roles & responsibilities for each of the functional
groups within the newly redeveloped Emergency
Response Structure.
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PUBLIC HEALTH AGENCY OF CANADA
In 2006-07, the Agency led the development of a
pandemic influenza exercise named Coherence
Trecedim II, a Tabletop Exercise for the 2006
National Forum on Emergency Preparedness and
Response. Over 200 stakeholders from the provinces,
territories, non-governmental organizations and the
federal government took part. The exercise provided
insight into the Agency’s capacity to communicate
with our partners and stakeholders, and with the
general public, during a pandemic. This exercise
focused, in part, on gaps identified during the 2005
National Forum exercise.
A series of consultations and workshops were held on
emergency preparedness and at-risk groups, such as
seniors, persons with disabilities, and children, to
develop a more coordinated mechanism to address
their needs in emergencies. This included
collaboration with the World Health Organization on
the organization of two international workshops
focusing on older persons in disasters. Additionally,
the Agency and the Canadian Psychological
Association co-hosted a roundtable of key
psychosocial and disaster mental health planning to
identify key issues and priorities for preparing to
manage the emotional and behavioural impacts of
emergencies.
The Agency supported the development of the
Voluntary Sector Framework for Health Emergencies
and the formation of the Council of Emergency
Voluntary Sector Directors comprised mainly of the
major NGOs and voluntary organizations. This is
intended to enhance coordination of preparedness,
response and recovery activities across the nongovernmental and voluntary health sector.
Emergency Response Capacity
Planned ($M)
Authorities ($M)
Actual ($M)
9.1
14.0
12.0*
* Actual spending was $2.0 million lower than authorities due to capacity and technical constraints.
WHAT WAS PLANNED
In 2006-07, the Agency committed to:
n Maintain its 24-hour/7-day response capability
and the ability to deliver supplies from the National
Emergency Stockpile System (NESS) anywhere in
Canada within 24 hours;
n Improve its laboratory response operations in both
its first laboratory and its mobile response units
and develop enhanced field-usable techniques for
the identification of potential bacterial bioterrorism
agents. Testing capacity at the Agency’s Canadian
laboratories will also be enhanced;
n Contribute directly to Canada’s participation in the
Global Health Security Initiative, an international
Partnership established to address the threats of
chemical, biological, radiological and nuclear
terrorism as well as pandemic influenza;
n Take steps to ensure that yellow fever vaccine is
dispensed in Canada in accordance with national
standards;
n Work in collaboration with the Pan-Canadian
Public Health Network toward the establishment of
a federal, provincial and territorial Public Health
Mutual Aid Agreement;
n Staff, train and supply one Health Emergency
Response Team (HERT) that would assist the
provinces and territories to create surge capacity in
the event of public health emergencies;
n Collaborate with provincial and territorial government emergency preparedness authorities to refine
region-specific planning and act as a liaison with
other federal government departments; and
n Create a permanent executive liaison function with
the National Emergency Response System.
WHAT WAS ACHIEVED
The Agency maintained its 24/7 response capability
and 24-hour delivery commitment for its National
Emergency Stockpile System (NESS). To remain able
to respond to new and emerging threats, the Agency
completely reviewed NESS holdings using an up-todate Risk and Threat Assessment. The Agency, in
collaboration with the provinces and territories, continued to build an effective stockpile of critical supplies
including anti-viral drugs in order to respond to
pandemic and other public health emergencies. By
modernizing NESS, and by supporting and facilitating
the national dialogue on emergency measures under
an all-hazardous approach, the Agency continued to
improve its pandemic influenza preparedness in
2006-07.
In support of Canada’s participation in the Global
Health Security Initiative’s Global Health Security
Action Group Laboratory Network, the Agency started
developing an Environmental Sampling Framework
for use after a bioterrorist event.
n Further connect the Emergency Operations Centre
(EOC) to provincial, territorial and international
networks;
The Agency provided training to the Health Portfolio
for the Transportation of Dangerous Goods, including
infectious substances, hazardous chemical and
radioactive substances. The Agency also developed
and offered train-the-trainer courses on this topic.
n Define the federal, provincial and territorial
components of the National Health Emergency
Management System;
The Agency assisted the Department of Foreign Affairs
and International Trade with the Canadian implementation of the Biological Toxins and Weapons Conven-
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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27
tion. The Agency was a member of the Canadian
delegation to the United Nations where significant
progress was made to improve international participation in the annual Confidence Building Measures
report process.
Canada chaired a lab network (GHSAG-LN) of the
G7 countries plus Mexico. In this forum the Agency
contributed to significant progress, including
exchange of critical testing protocols for situations of
suspected bioterrorism.
Public health security was enhanced by the Agency
through the provision of essential up-to-date information on international public health to Canadian
travellers and front-line health care workers. To be
effective, the program utilized tools such as the
Global Public Health Intelligence Network (GPHIN),
which anticipates and tracks infectious diseases using
software to monitor large volumes of worldwide news
related to infectious and chronic disease, natural
disasters, environmental and agricultural concerns
that might affect the health of Canadian travellers.
Canadian traveller health was further protected as the
Agency’s Travel Medicine Program dispensed yellow
fever vaccine in accordance with national standards
in 2006-07. A review of the program, initiated to
ensure that the program would meet Canada’s yellow
fever vaccination obligations under the revised
International Health Regulations (2005), highlighted
the need for further collaboration with the provinces
and territories to modernize vaccine delivery.
The Agency continued to provide the official federal
representation as well as secretariat, policy, technical,
and financial support to the Emergency Preparedness
and Response Expert Group of the Pan-Canadian
Public Health Network. This Expert Group’s role is to
enhance emergency preparedness and response
capacity across Canada through the development of
evidence-based frameworks and practices that
encompass the full spectrum of emergency management including mitigation, preparedness, response,
and recovery from a federal, provincial and territorial
context.
28 |
PUBLIC HEALTH AGENCY OF CANADA
The Agency played a key role in the development of
the Federal, Provincial, and Territorial Memorandum
of Understanding on the Provision of Mutual Aid in
Relation to Health Resources during an Emergency.
This work, which was tasked to the Expert Group on
Emergency Preparedness and Response by the PanCanadian Public Health Network, was completed and
the agreement was ready for sign off by the Federal,
Provincial, and Territorial Ministers of Health.
The Agency was not able to field the first Health
Emergency Response Team (HERT) as had been
planned. The National Office of Health Emergency
Response Teams continued to address all aspects of
establishing these teams of health professionals from
outside the federal government who will provide
medical surge capacity. A draft operational framework was developed, and the Agency completed 80%
of the procurement of equipment for the first HERT
Unit. Work was initiated with Central Agencies on
mechanisms to engage HERT volunteers, and with the
Federation of Medical Regulatory Authorities of
Canada on cross-border Provincial, and Territorial
licensure. Revised timelines for HERT include commissioning an Ottawa team in 2007, Vancouver and
Halifax teams during 2008 and a Winnipeg team by
2009.
Plans to establish a permanent executive liaison
function to Public Safety Canada (PSC) were held in
abeyance while the Agency worked to establish the
necessary conditions. However, the Agency continued
working with PSC and other federal departments
within the Government of Canada’s National
Emergency Management framework.
With its work on the National Health Emergency
Management System, the Agency made significant
progress toward completing the main mapping
document of the System’s federal, provincial and
territorial components, and this work will continue.
The Agency continued to maintain the Emergency
Operations Centre (EOC) system for the federal
Health Portfolio. The EOC provides the platform from
which the Agency and Health Canada will respond to
any public health emergency. Development of new
emergency management software that integrates geo-
spatial technology continued during the year. The
Agency also participated in an interdepartmental pilot
project to enable easier, more efficient sharing of
information and data among federal, provincial, and
territorial partners and stakeholders in routine and
emergency situations.
The Agency hosted, in Ottawa, the first international
meeting of Regulators of the Contained Use of
Human Pathogens. This saw the participation of
representatives from the US (the Centres for Disease
Control and Prevention), Switzerland, UK, Australia,
Japan, and Singapore as well as the World Health
Organization.
In summary, the Agency accomplished all emergency
response capacity activities planned in the 2006-07
Report on Plans and Priorities, with the exception of
establishing the complete Health Emergency
Response Team (HERT) and creating a permanent
executive liaison function with the National
Emergency Response System.
Infectious Disease Prevention and Control
Despite recent advancements in prevention, treatment
and control, the number of Canadians dying from or
living with infectious diseases has been climbing since
the 1980s, due in part to HIV/AIDS. An estimated
58,000 Canadian residents are living with HIV, and
approximately one quarter of them are unaware of
their condition.
need for comprehensive national approaches across
groups of infectious diseases.
The unpredictability and dynamic evolution of disease
causing biological agents (pathogens), the animal
origins of emerging and re-emerging infectious
diseases and the spread of antimicrobial-resistant
organisms and hospital acquired infections are
creating formidable challenges for the prevention and
control of infectious diseases.
In addition, the potential for co-infection by multiple
micro-organisms with common risk factors, vulnerable
populations and modes of transmission increases the
Communicable Disease Control Expert
Group
The Agency continued to provide the official
federal representation as well as secretariat,
policy, technical, and financial support to the
Communicable Disease Control Expert Group of
the Public Health Network. The Expert Group’s
role is to provide strong leadership in
communicable disease prevention and control
through the development, recommendation and
implementation of national policies, practices,
guidelines and standards from a federal,
provincial and territorial context.
Pandemic Influenza Preparedness
Planned Spending ($M)
Total Authorities ($M)
Actual Spending ($M)
92.6
36.7*
30.9**
** The $55.9 million difference between the planned spending and total authorities is due mainly to funding being reprofiled
to subsequent fiscal years and distributed to other programs to support their pandemic related initiatives.
** Actual spending was $5.8 million lower than authorities due to capacity and technical constraints. $2.2 million occurred
because reprofiling was denied for vaccine readiness and surveillance tools, and $1.2 million stemmed from an
uncontrollable delay in contracting for work on a Winnipeg laboratory expansion project.
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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29
WHAT WAS PLANNED
Recognizing that an influenza pandemic has the
potential to be the largest public health infectious
disease emergency in Canadian history, the Agency
planned to take a leadership role in the publication of
the updated Canadian Pandemic Influenza Plan for
the Health Sector, and in promoting implementation
of the update by all levels of government.
The Plan includes ensuring that there is an adequate
domestic capacity to produce appropriate pandemic
influenza vaccine. The Agency also made it a priority
to appropriately increase and diversify the stock of
antivirals for treatment.
WHAT WAS ACHIEVED
The Agency took a leadership role in updating and
publishing the updated Canadian Pandemic Influenza
Plan for the Health Sector in December 2006, in
collaboration with the provinces and territories. The
Agency also promoted that the updated plan be
adopted by all levels of government.
The Agency took steps to strengthen Canada’s
capacity to prepare for and respond to the threat of
avian and pandemic influenza in seven major areas:
n prevention and early warning;
n vaccines and antivirals;
n coordination capacity;
n emergency preparedness;
n critical science;
n risk communications; and
n federal/provincial/territorial and international
collaboration.
Prevention and Early Warning
Effective and timely surveillance is critical to the ability
of the government to accurately detect, monitor and
respond to an emerging infectious disease. The
Agency continued to support the integrated public
health information system (iPHIS) and undertook
necessary enhancements such as the improved
capability to extract pertinent data thereby ensuring
30 |
PUBLIC HEALTH AGENCY OF CANADA
that the system is ready if called upon for responding
to potential outbreaks and health emergencies.
Vaccines and Antivirals
Immunization is an important element of an effective
response to pandemic influenza. Canada is now
better prepared to develop and deliver a pandemic
influenza vaccine. The Agency continued to administer a 10-year contract between ID Biomedical Corporation (operating as GlaxoSmithKline Biologicals
North America) and the Government of Canada to
develop and maintain domestic pandemic vaccine
production capacity. The Agency also continued to
administer a 2005 amendment to that contract for
production and testing of a prototype pandemic
vaccine, including conducting clinical trials, which will
build upon current, company sponsored, trials and
which will address issues of specific concern to
Canada.
The Agency continued discussions with the vaccine
manufacturer, GlaxoSmithKline, concerning enhanced pandemic readiness through access to
expanded production capacity, potential regional
projects for adverse event reporting, and strengthening adverse event surveillance and reporting.
A component of the preparation for an influenza
pandemic is establishing a reserve of antiviral
medication. During 2006-07 the National Antiviral
Stockpile (NAS) for early treatment of pandemic
influenza was expanded to 51 million doses, as
approximately 21 million additional doses were
delivered to provinces and territories. This initiative
was funded through a cost sharing arrangement
between the Agency and provincial & territorial
governments. Also during 2006-07, in collaboration
with the provinces and territories, the Agency led the
development of a national policy recommendation on
the advisability of stockpiling antivirals for prevention
during a pandemic; this is to be submitted to federal,
provincial, and territorial Ministers of Health later
during 2007.
Coordination Capacity
With the increasing profile of pandemic influenza
issues, there was an urgent need to strengthen the
Agency’s capacity for strategic policy to support
federal, provincial, and territorial relations, executive
support and corporate correspondence. A Pandemic
Preparedness Secretariat, led by a Director General,
was established and began to provide a focal point for
Agency participation in federal, provincial, territorial,
cross-sectoral and international work to improve
Canada’s avian and pandemic influenza preparedness.
Emergency Preparedness
Emergency preparedness activities are critical in order
to adequately prepare for, respond to, and recover
from the public health implications of avian or
pandemic influenza.
The Agency worked with Public Safety Canada (PSC)
on establishing an interdepartmental protocol for
early notification and liaison and also continued
developing the National Health Incident Management
Agency Success Across Canada: Pandemic and
Avian Influenza Planning
In 2006-07 the Agency collaborated with partners
from federal and provincial governments, as well as
essential partners from the non-governmental and
private sectors, in planning for pandemic influenza
and avian influenza emergencies.
The Agency’s Manitoba/Saskatchewan Office was
instrumental in building strategic partnerships with
the development of the Joint Federal – Provincial
H5N1 Avian Influenza Planning Group, whose
members represent several federal and provincial
departments, non-governmental organizations and
the poultry industry. This group is now developing
an intersectoral plan for coordinated management
of an avian influenza emergency in Manitoba, and
the Agency led federal participation during
preparatory exercises testing the Groups
operational effectiveness. Also, the Agency
System (NHIMS) with provinces and territories to
facilitate the coordination of planning and response
mechanisms both within and across jurisdictions
during emergencies.
The Agency, with Public Safety Canada, the Department of Foreign Affairs and International Trade and
the Canadian Food Inspection Agency, co-developed
a North American Avian and Pandemic Influenza Plan
with the United States and Mexico to 1) detect, contain and control an avian influenza outbreak and
prevent transmission to humans; 2) prevent or slow
the entry of a novel strain of human influenza to
North America; 3) coordinate emergency management and communications; 4) minimize unwarranted
disruptions to the flow of people, goods and services
at the borders and 5) sustain critical infrastructure.
provided essential training in emergency management and pandemic influenza planning to
participants.
In Atlantic Canada the Agency and Public Safety
Canada (PSC) co-sponsored a meeting on June 8,
2006 of representatives of key provincial and
federal departments and agencies to discuss emergency pandemic influenza planning. Representatives from the four Atlantic provinces’ Departments
of Health, Emergency Measures Organizations, and
Health Emergency Management organizations
attended along with regional representatives of the
Agency, Health Canada and PSC. The meeting
provided an opportunity to share information, clarify roles and responsibilities and identify common
issues and themes with the objective of facilitating
ongoing collaboration and coordination in the
region – an important first step in emergency
pandemic influenza preparedness.
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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31
Critical Science
The Agency’s National Microbiology Laboratory
(NML) conducts scientific research and development
in a wide range of areas related to viral, bacterial and
prion infectious agents. As Canada’s leading laboratory with high-containment facilities (Levels 3 and 4),
NML is uniquely positioned to rapidly isolate, identify
and characterize novel agents (e.g., new strains of
influenza virus) as they arise periodically, using a
variety of advanced technology applications built on
genomics, proteomics and biocomputing. NML is also
in the forefront in development of these modern public health technologies, applying them to diagnostics,
vaccines, and molecular epidemiology.
On a less specialized level, NML’s scientists work
continuously to collect laboratory data on infectious
agents and diseases of importance both in Canada
and internationally. These data are translated by
regulators (e.g., Health Canada, Canadian Food
Inspection Agency) and federal, provincial, and
territorial public-health stakeholders into risk assessments, decisions, policies and guidelines for disease
prevention, treatment, control and management.
Internationally as well, NML’s contribution is increasingly valued by collaborating organizations such as
the World Health Organization. Through NML, the
Agency’s reach has been extended globally through
its capacity to transfer and deploy its expertise to other
countries, and through its support for professional
interchange.
Examples of active areas for structured public health
intervention based on laboratory data are food safety
(enteric pathogens, BSE); blood safety (hepatitis
viruses, variant Creutzfeldt-Jakob disease); zoonotic
diseases (West Nile Virus, influenza virus); hospital
infection control (antimicrobial-resistant bacteria); and
travel and quarantine (drug-resistant tuberculosis). In
a less direct way, safer community environments are
also promoted, by using laboratory data to reduce the
impact of community-acquired diseases such as
pneumonia, tuberculosis and sexually transmitted
infections, particularly in vulnerable populations such
as those in day-care centres and long-term care
facilities.
32 |
PUBLIC HEALTH AGENCY OF CANADA
NML operated at full capacity during the year. To
help keep laboratory capacity and scientific activity
commensurate with public health needs, during
2006-07 the Agency successfully brought forward
a plan for the purchase of a provincially-owned
laboratory facility (the Logan Lab); purchased
necessary equipment and began migration of
selected administrative services which had been
housed at NML to an office building in the downtown area.
Risk Communications
Risk communications has been recognized as a vitally
important public health intervention. The Agency
conducted public consultations and public opinion
research on key issues related to pandemic influenza
that will inform both the Agency’s policy development
and communications planning. Public information
materials, including two posters and a brochure,
were produced, translated into multiple languages
and distributed to key stakeholders. Public service
announcements that would offer Canadians
information about pandemic influenza and how
they can protect themselves were produced for
radio, Web and print media, in preparation for a
pandemic.
The Agency also continued to strengthen its networks
with provincial and territorial counterparts, as well
as with international partners, in the area of
communications.
Federal, Provincial, and Territorial and
International Collaboration
To address the shortages which limit the ability of
provinces and territories and local public health
authorities to meet the Agency’s priorities for
surveillance and response, the Agency established the
Public Health Service Program. The Agency engaged
core staff and undertook initial consultation for
internal collaboration among field staff programs and
completed the first round of consultations with
provincial and territorial governments. This formed
the basis for a second round of talks with provinces
and territories and the establishment of official
agreements to deploy Public Health Officers in the
next fiscal year.
The Agency provided a $1 million grant to support
the implementation of the WHO Global Action Plan
to increase global pandemic influenza vaccine supply.
Immunization
Planned ($M)
Authorities ($M)
Actual ($M)
10.0
9.9
8.6*
* Actual spending was $1.3 million lower than authorities due to capacity and technical constraints.
WHAT WAS PLANNED
Immunization has proven to be one of the most
effective types of public health intervention. Consistent
with the National Immunization Strategy, which was
accepted by the Conference of Federal, Provincial
and Territorial Deputy Ministers of Health in 2003,
the Agency planned to provide scientific, program,
policy, information dissemination, coordination and
administrative support to the federal, provincial and
territorial Canadian Immunization Committee (CIC),
and the National Advisory Committee on Immunization (NACI) under the auspices of the Pan-Canadian
Public Health Network, and to collaborate
internationally on issues related to immunization and
vaccine-preventable infectious diseases.
WHAT WAS ACHIEVED
The planned initiatives were met and in some cases
exceeded.
The Agency provided scientific, program, policy, information dissemination, coordination and administrative support to the federal, provincial and territorial
Canadian Immunization Committee, and the National
Advisory Committee on Immunization under the
auspices of the Pan-Canadian Public Health Network.
With Agency participation and administrative support,
NACI published the 7th edition of the Canadian
Immunization Guide and distributed approximately
40,000 copies nationally. Also with Agency participation and administrative support NACI released
its public health recommendations for the human
papillomavirus (HPV) vaccine, the first vaccine
approved for use in Canada to protect women and
girls against cervical cancer. In order to facilitate
timely and equitable access across Canada, Budget
2007 provided $300 million over three years to
provinces and territories to launch HPV vaccine
programs. The Agency took the leadership role in
coordinating Canada’s first collaborative immunization program planning exercise. Both national
committees, CIC and NACI, formed a joint task force
to evaluate options and provide evidence to inform
immunization programming planning decisions
focussing on this vaccine.
The CIC approved the national cold chain guidelines
for publications, received approval from the PanCanadian Public Health Network to adopt the
national goal for eliminating rubella and congenital
rubella syndrome, and approved national goals and
recommendations for five vaccine preventable
diseases: influenza, invasive pneumococcal disease,
invasive menningococcal disease, varicella and
rubella. Under the guidance of the CIC an external
consultant evaluated the National Immunization
Strategy three years into its mandate.
The Agency published the Canadian National Report
on Immunization, including information on vaccine
preventable disease epidemiology, vaccine coverage,
vaccine safety/adverse events, and progress with the
National Immunization Strategy. Also published were:
n Guidelines for Prevention and Control of Invasive
Group A Streptococcal Disease; and
n Data on Enhanced Surveillance of Invasive
Meningococcal Disease (2002-2003).
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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33
To collaborate internationally on issues related to
immunization and vaccine-preventable infectious
diseases, the Agency worked with international
agencies such as the World Health Organization and
the Pan American Health Organization, continuing to
provide technical leadership and advice for vaccinepreventable disease elimination and eradication
globally. The Agency also participated in the
International Circumpolar Surveillance Initiative in
order to better understand the epidemiology of a
variety of invasive bacterial diseases above the 60th
parallel.
In collaboration with the Canadian Paediatric Society
and the Canadian Association for Immunization
Research and Evaluation, the Agency organized a
Canadian Immunization Conference, which took
place December 3-6, 2006, in Winnipeg, Manitoba,
and drew more than 1,000 participants. The
exchange of ideas and expertise at this conference is
expected to help stimulate both the development and
application of new scientific and technological
advances.
Bloodborne Disease and Sexually Transmitted Infections
Planned ($M)
Authorities ($M)
Actual ($M)
52.8
52.8
52.8
There has been a steep increase in sexually transmitted infections over the last decade, and rising coinfections of HIV with diseases such as tuberculosis,
hepatitis C and syphilis.
WHAT WAS PLANNED
In 2006-07 the Agency planned:
n to lead the Federal Initiative to Address HIV/AIDS
in Canada;
n to put in place an approach to address the shared
needs of discrete population groups at-risk of HIV/
AIDS;
n to distribute national STI guidelines to health care
practitioners and clinics across Canada;
n to monitor the infection rates of a wide range of
sexually transmitted and bloodborne infections;
and
n to use the Enhanced Surveillance of Canadian
Street Youth to provide a comprehensive picture of
the health of Canadian street youth including risk
factors;
n to identify “best practice” models of school-based
sexual health promotion.
34 |
PUBLIC HEALTH AGENCY OF CANADA
WHAT WAS ACHIEVED
All these plans were accomplished during 2006-07.
The Agency continued to lead the Federal Initiative to
Address HIV/AIDS in Canada. The Federal Initiative is
a partnership among the Agency, Health Canada, the
Canadian Institutes of Health Research and
Correctional Service Canada. Its aim is to prevent
new infections, slow the progression of HIV/AIDS,
improve the quality of life for affected people, reduce
the social and economic impact of the disease, and
contribute to the global efforts against the epidemic.
Through this initiative, the Agency continued its efforts
to strengthen the knowledge of HIV/AIDS to provide
better information on prevention, care, treatment and
support programs; increase public awareness of HIV/
AIDS and factors that fuel the epidemic, such as
stigma and discrimination; integrate, when
appropriate, HIV/AIDS programs and services with
those addressing other related diseases, such as STIs;
engage federal departments in addressing factors that
influence health, such as housing and poverty;
increase Canadian participation in the global
response to HIV/AIDS; and support partners to
implement effective interventions to address HIV/
AIDS.
During 2006-07, the Agency worked with national
and international partners to update the estimates of
national HIV incidence and prevalence in Canada for
2005. The new estimates were released prior to the
International AIDS Conference in Toronto in August
2006 and are now being used to guide program and
policy actions. The Agency also continued to develop
Canada’s second-generation HIV surveillance program for monitoring HIV and related risk behaviours
among groups at high risk for HIV infection. The
monitoring program for people who use injection
drugs now has sites from Quebec to British Columbia,
while the program for men who have sex with men
completed its first round of surveys in Montreal and in
Ontario. A similar pilot study for people from countries
where HIV is endemic was started in the Montreal
Haitian community.
As part of its efforts to contribute to the global
response, the Agency supported the Canadian HIV
Vaccine Initiative, announced by the Prime Minister in
February 2007, to develop safe and effective HIV
vaccines. The Agency’s partners in this Initiative
include Health Canada, the Canadian Institutes of
Health Research, the Canadian International
Development Agency (CIDA), Industry Canada, and
the Bill & Melinda Gates Foundation. Also, the
Agency supported the establishment of an effective
second-generation HIV/AIDS surveillance system in
Pakistan, which is being funded by CIDA. The
information acquired through this system will be used
by the Government of Pakistan to monitor the
epidemic and to plan, implement and evaluate an
expanded response.
The HIV Genetics Research Program continued its
work in the field of molecular epidemiology, allowing
researchers to use the genetic code of HIV sub-types
to assist public health efforts by identifying clusters of
infections, supporting outbreak investigations and
informing prevention efforts for specific target groups.
2006, and in partnership with Health Canada, First
Nations and Inuit Health Branch (FNIHB), to produce
the first HIV/AIDS Aboriginal Attitudinal Survey 2006.
These surveys offered an overall picture of knowledge,
attitudes and behaviours related to HIV/AIDS in
Canada, and insight into the extent and causes of
HIV/AIDS related stigma and discrimination, providing the foundation towards the development of the
first national Agency-led HIV/AIDS social marketing
campaign.
The Agency participated in a multi-stakeholder project
to create a Canadian HIV Vaccines Plan which outlines a wide range of recommended actions for
researchers, government, community and international
organizations. This plan has been recognized internationally as one of the first country wide HIV vaccine
plans that promotes a comprehensive strategy for
vaccine, advocacy and funding. The Canadian HIV
Vaccines Plan can be found at: http://www.phacaspc.gc.ca/aids-sida/pdf/publications/
vaccplan_e.pdf.
Through the AIDS Community Action Program, the
Agency continued to fund community-based
organizations to support the delivery of HIV/AIDS
prevention education, to create supportive environments for those infected with and affected by HIV/
AIDS, and to increase the capacity of people living
with HIV/AIDS to manage their condition through 148
projects across Canada.
During 2006-07, steps were taken to address the
shared needs of discrete populations at risk of HIV
infection by launching the new Specific Populations
HIV/AIDS Initiative Fund. Experts and stakeholders
were engaged to assist the development of
Population-Specific HIV/AIDS Status Reports for gay
men, for women, for Aboriginal people, and for
people from countries where HIV is endemic.
The Agency worked with EKOS Research Associates to
produce the HIV/AIDS Attitudinal Tracking Survey of
DEPARTMENTAL PERFORMANCE REPORT 2006–07
|
35
SUCCESS STORIES
In 2006-07, the Agency’s Quebec Region provided
financial support for the Refugee Project (Projet
pour les réfugiées), to develop mechanisms for
collaborative action adapted to refugees’ particular
health needs. With partners including Royal Victoria
Hospital, St Justine’s Hospital, the Centre Social
d’Aide aux Immigrants, the Service d’Aide aux
Réfugiés et Immigrants, and Maison Plein Coeur
the project is designed to provide people living with
HIV/AIDS who have applied for, or been granted
refugee status, access to health services and
support to develop social and community networks
that will further their integration into society.
Reducing social isolation is viewed as key to
improving the health status of this population, and
project benefits have already been noted at the
local, regional and national levels.
The Agency’s Ontario/Nunavut Region developed
and distributed the first annual Ontario Community
HIV/AIDS Reporting Tool (OCHART) report titled
The View from the Front Lines. This report provides
a summary and analysis of data collected by the
Ontario Ministry of Health and Long-term Care and
from four years of Agency-funded projects using a
tool jointly developed by both levels of government.
The analysis was designed to provide a general
The 2006 Canadian Guidelines on Sexually
Transmitted Infections, which represents the most
current available knowledge on the management of
sexually transmitted infections, was made available to
health care professionals on the Agency website.
Agency officials participated in the expert working
group which developed these guidelines.
The Agency continued to monitor the infection rates
of a wide range of sexually transmitted and
bloodborne infections, and to undertake blood safety
surveillance including building the necessary
leadership, scientific expertise and infrastructure to
support its ongoing core surveillance projects directed
towards the collection of detailed information on:
36 |
PUBLIC HEALTH AGENCY OF CANADA
picture of HIV/AIDS prevention, care and support
activity in Ontario. The report provides invaluable
intelligence to the AIDS Bureau, the Agency and the
funded agencies helping to understand the demand
for services, identify any shifts and changes in
trends and provides an evidence base for future
research and prevention projects. The OCHART
report may be viewed at the following link: https://
www.ochart.ca/OCHART%20Report%20March%20
(Final%202006-03-19).PDF.
The Agency’s Ontario/Nunavut Region commissioned the Youth Engagement Research Unit at the
University of Toronto Centre for Health Promotion
to carry out an environmental scan of youth
engagement activities in Ontario. Interviews were
conducted with youth organizations in urban, rural
and remote communities to identify existing
activities and networks, with a focus on hepatitis C,
HIV and sexually-transmitted infections and the
determinants of health. A final report identified
gaps, opportunities, successes and challenges of
youth engagement activities, and provided
recommendations for the development of a
regional youth network. For more information see:
http://www.youthvoices.ca.
n Risk factors on bloodborne pathogens like
hepatitis B, C viruses and HIV in the general
population as well as in occupational settings. This
included projects like the Enhanced Hepatitis Strain
Surveillance System (EHSSS) and the Canadian
Needle Stick Surveillance System (CNSSN).
n Incidence of adverse transfusion events and
transfusion errors. This included projects such as
the Transfusion Transmitted Injuries Surveillance
System (TTISS) and the Transfusion Error
Surveillance System (TESS).
The Agency has also undertaken efforts to broaden
networks and increase knowledge transfer activity to
better manage public health risks across Canada. As
examples, the Agency is in the process of assessing
data from Canadian hospitals related to accurate and
ongoing neonatal/paediatric transfusions as well as
blood conservation for transfusion purposes. The aim
is to develop better approaches, relevant risk
evaluations and equations, and the development of
options to better protect Canadians from existing,
emerging and re-emerging infectious diseases.
and health determinants in this population. This
surveillance pilot project, undertaken in collaboration
with external stakeholders, led to the development of
more effective mechanisms to reach street youth and
provide testing and care for HIV, sexually transmitted
infections and related infections.
Work was also conducted towards the development of
data standards for sexually transmitted and
bloodborne infections in order to improve national
data quality and timeliness.
The Agency used the Enhanced Surveillance of
Canadian Street Youth (E-SYS) system to provide a
comprehensive picture of the health of Canadian
street youth. Based on data from the Enhanced
Surveillance of Canadian Street Youth system, several
reports were released on rates of sexually transmitted
infections and bloodborne infections, risk behaviours
“Best practice” models of school-based sexual health
promotion were identified so that future initiatives
could be more effective.
Health Care Acquired Infections
Planned ($M)
Authorities ($M)
Actual ($M)
3.7
3.6
3.6
WHAT WAS PLANNED
It is estimated that about 5% to 10% of all patients
who enter a Canadian health care facility will develop
a health care acquired (Nosocomial) infection. To
address this, the Agency’s plans for 2006-07 were to:
n expand the scope of its Infection Control
Guidelines, including using survey information to
revise the Guideline on Routine Practices and
Additional Precautions for Preventing the
Transmission of Infection in Health Care.
n update the Infection Control and Occupational
Health Guidelines During Pandemic Influenza In
Traditional and Non-Traditional Health Care
Settings, as part of the Canadian Pandemic
Influenza Plan; and
n complete analysis of a previously conducted
Clostridium difficile (C. difficile) survey and publish
a report.
WHAT WAS ACHIEVED
The Agency reviewed, revised, and expanded the
scope of its the Infection Control Guideline Series,
which are widely used by health care providers,
governments and other institutions to provide bestpractice information on the prevention and control of
infections. These guidelines now have been adapted
for the entire spectrum of Canadian health care
providers, such as acute care and long-term care
institutions, office and outpatient care, and home
care. The Guidelines can be found at: http://
www.phac-aspc.gc.ca/dpg_e.html#infection.
Revision of the Infection Control Guidelines was
accomplished in collaboration with a national and
multi-disciplinary steering committee, reporting to the
Communicable Disease Control Expert Group
(CDCEG) of the Pan-Canadian Public Health
Network. The steering committee was established as
an advisory and directing body to facilitate the
development and maintenance of the Public Health
Agency of Canada’s Infection Control Guideline
Series.
The Agency advanced its work reviewing and revising,
as part of the Canadian Pandemic Influenza Plan
(CPIP), Annex F: the Infection Control and Occupation
Health Guidelines during Pandemic Influenza in
Traditional and Non-Traditional Health Care Settings.
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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The work was accomplished in collaboration with a
multi-disciplinary team from across Canada.
Clostridium difficile (C. difficile) is the most common
cause of infectious diarrhea in hospitals in the
industrialized world. During 2006-07, the Agency
also completed its analysis of a previously conducted
C. difficile survey, designed to identify the infection
prevention and control practices that are in place in
all Canadian acute care and long term care facilities.
This study also determined if there were differences
between infection control practices in larger or
smaller hospitals as well as differences between acute
care hospitals and long term care facilities. Results
from the survey will allow inter-provincial/territorial
comparisons of routine infection control practices and
added precautions related to C. difficile associated
diarrhoea. Results will also enable single institutions
to compare their infection control practices to those of
similar institutions.
The Canadian Nosocomial Infection Surveillance
Program (CNISP) represents a collaborative effort of
the Agency and of the Canadian Hospital
Epidemiology Committee (CHEC), a subcommittee of
the Association of Medical Microbiology and
Infectious Disease Canada. The objectives of CNISP
are to provide rates and trends on nosocomial
infections at Canadian health care facilities thus
enabling comparison of rates (benchmarks), and
providing evidence-based data that can be used in
the development of national guidelines. CNISP
network expansion in major teaching hospitals is
critical towards reaching community care and longterm care facilities, in order to develop a complete
national health care-acquired infection surveillance
program. During 2006-07, CNISP network of sentinel
hospitals expanded to 49, so that the Agency’s plan
was achieved.
In summary, the Agency accomplished all activities
planned for Health Care Acquired Infections in the
2006-07 Report on Plans and Priorities with the
exception of revising the Guideline on Routine
Practices and Additional Precautions for Preventing the
Transmission of Infection in Health Care.
Animal-to-Human (Zoonotic) Diseases
Planned ($M)
Authorities ($M)
Actual ($M)
20.7
20.4
18.7*
* Actual spending was $1.7 million lower than authorities due to capacity and technical constraints.
WHAT WAS PLANNED
The economic effects of diseases that can be transmitted between animals and humans (zoonotic
diseases) range from lost productivity to restrictions on
international trade and travel. With its specialized
laboratories, the Agency is taking national leadership
in addressing such diseases. During 2006-07 the
Agency planned to:
n continue research on and surveillance of the West
Nile virus in an effort to minimize the risk to
Canada’s blood supply;
n update existing guidelines and host a national
conference on Lyme disease;
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PUBLIC HEALTH AGENCY OF CANADA
n continue its collaboration with regional health
authorities across Canada in the implementation of
the Canadian Network for Public Health
Intelligence (CNPHI)
n perform expert microbiological reference testing
and carry out innovative research to improve
Canada’s capacity for identifying viruses and
bacteria
n continue to generate, synthesize and communicate
science-based information related to the
prevention and control of public health risks
associated with infectious gastrointestinal diseases
at the human, animal and environmental interface;
n through the National Enteric Surveillance Program
(NESP), continue to collect, and disseminate
weekly, laboratory-based data on human
gastrointestinal pathogens;
n continue to study the incidence, burden, cost and
risk factors, and the phenomenon of underreporting, of infectious gastrointestinal illness in
Canada; and
n lead the development of a national contingency
plan for raccoon rabies.
WHAT WAS ACHIEVED
Through the Foodborne, Waterborne and Zoonotics
Infections Division and the National Microbiology
Laboratory, the Agency continued research on and
surveillance of the West Nile virus. Through the
National West Nile Virus Surveillance Program, the
Agency continued to lead the federal government’s
response to West Nile virus. The program coordinates
overall federal, provincial and territorial West Nile
virus-related activities, including surveillance, public
education and awareness, and research into the
ecology, spread and risk factors of the disease. This
work was done in collaboration with Canada’s blood
agencies.
The Agency hosted a national conference on Lyme
disease, as a first step toward providing recommendations for updating existing Lyme disease guidelines.
The Agency continued its collaboration with regional
health authorities across Canada in the implementation
of the Canadian Network of Public Health Intelligence
(CNPHI) which was expanded to provide additional
Web-based resources, including outbreak summaries
of foodborne and waterborne disease, web-NESP
(National Enteric Surveillance Program), syndromic
surveillance data, infectious disease modelling tools
and West Nile virus surveillance. A special dataextraction method was used to integrate CNPHI
information with existing federal, provincial, and
regional public health databases while maintaining
the confidentiality of personal data and respecting
jurisdictional responsibilities. CNPHI was also made
available to other government departments with public health links, creating broader intergovernmental
integration, to facilitate the necessary collection and
processing of surveillance data, dissemination of
strategic information, and coordination of responses
necessary to meaningfully address these public health
threats.
Performing expert microbiological reference testing
and carry out innovative research to improve
Canada’s capacity for identifying viruses, prions, and
bacteria relied on Agency expertise in laboratory
biosafety, which is recognized worldwide, and on the
high-level containment capacity of the Canadian
Science Centre for Human and Animal Health in
Winnipeg, which houses both the Agency’s National
Microbiology Laboratory (http://www.nml.ca/english/
index.html) and the Canadian Food Inspection
Agency’s National Centre for Foreign Animal
Disease.
Agency laboratories continued to perform such
reference testing and research, which is often used to
support surveillance and outbreak investigation. For
example, the Agency provides routine and reference
diagnostics for a wide range of zoonotic disease
agents, many of which are not tested for at the
provincial level. Laboratory-based surveillance
documents the circulation within Canada of diseases
such as Lyme disease, Q fever and hantavirus
pulmonary syndrome.
Innovative research using genome-based tools was
undertaken to develop methods for the rapid identification of disease agents (pathogens), for example,
the use of microarrays for typing Salmonella.
Through the National Enteric Surveillance Program
(NESP), the Agency continued to collect, and
disseminate weekly, laboratory-based data on human
gastrointestinal pathogens.
The Agency continued to study the incidence, burden,
cost and risk factors, and the phenomenon of underreporting, of infectious gastrointestinal illness in Canada.
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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SUCCESS STORY
Rift Valley Fever in Kenya
In December 2006, Kenya experienced an
outbreak of Rift Valley Fever (RVF) which affects
humans and animals. Kenya’s Ministry of Health
requested assistance from the World Health
Organization (WHO), which in turn solicited
diagnostic support in the form of a mobile
laboratory from the Agency’s National
Microbiology Laboratory. In January 2007, five
scientists from the Agency were selected to
participate in the mission and were deployed to
Kenyas’s Garissa District – the epicentre of the
outbreak. The Agency team provided guidance in
carrying out health care facility-based,
laboratory-based, and community-based
surveillance for RVF. Support was also provided
with surveillance data management, analysis,
interpretation and dissemination. This work is part
of the Agency’s commitment to assist in public
health emergencies anywhere in the world, and
will help prepare Canada for similar national
public health emergencies.
Canadian Public Health Laboratories Expert
Group
The Agency continued to provide the official
federal representation as well as secretariat,
policy, technical, and financial support to the
Canadian Public Health Laboratories Expert
Group of the Public Health Network. This Expert
Group’s role is to provide strong leadership in
public health laboratory functions through the
development of a proactive Federal and
Provincial network of public health laboratories,
as well as strategic direction in public health
laboratory science and diagnostics to protect the
health of Canadians.
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PUBLIC HEALTH AGENCY OF CANADA
The Agency also continued to generate, synthesize
and communicate science-based information related
to the prevention and control of public health risks
associated with gastrointestinal infectious diseases at
the human, animal and environmental interface.
Significant advances were made in the Canadian
Integrated Program for Antimicrobial Resistance
Surveillance (CIPARS). Changes in data management
allowed direct access to the most current data
available for reporting purposes and global analysis
for the stakeholders (CIPARS managers, Provincial
Public Health Laboratories and Animal Health
Laboratories participating in CIPARS). CIPARS
surveillance findings were used as a successful policy
lever whereby Quebec chicken industry groups banned
the use of a specific antibiotic (ceftiofur) on hatching
and day-old chicks; thus reducing drug resistance and
retaining a treatment option for humans.
The Agency also continued to provide national
coordination and support to the investigation and
control of outbreaks of foodborne and waterborne
diseases such as identification of outbreaks due to
fresh produce (e.g. spinach) and their recall from
retail sales.
In summary, the Agency accomplished all activities
planned for Animal-to-Human (Zoonotic) Diseases in
the 2006-07 Report on Plans and Priorities with the
exception of leading the development of a national
contingency plan for raccoon rabies and publishing
fully updated guidelines on Lyme disease.
Other Activities Associated with Infectious
Disease Prevention and Control
The Agency took steps to enhance programs in
biotechnology, genomics and population health,
through expanding capacity, base knowledge and
technical expertise aimed at increasing response and
action related to national public health threats.
Health Promotion and Chronic Disease Prevention
Planned ($M)
Authorities ($M)
Actual ($M)
284.7
222.6*
211.3**
** The difference between planned spending and authorities represents the provision of $51 million in funding to Health
Canada instead of the Agency for the Canadian Strategy for Cancer Control, and other funding reallocations totalling
$11.1 million.
** The $11.3 million difference between authorities and actual, approximately $8.0 million was due to constraints in
accommodations, staffing, and contracting which impeded reaching budgeted staff and operating levels. (Of this,
approximately $2.6 million was associated with the Integrated Strategy on Healthy Living and Chronic Disease.) Also, the
Agency’s regional organization was unable to use $2.3 million as planned for supporting demonstration projects.
Additionally $1.0 million in resources earmarked for launch of ParticipACTION could not be utilized for this purpose.
The Agency’s comprehensive approach to health
promotion and chronic disease brings together nongovernmental organizations, experts, provinces and
territories, and communities to improve the health of
Canadians, prevent injury, and reduce the incidence
of major chronic diseases such as heart disease and
stroke, cancer, diabetes, and respiratory disease.
The burden of preventable death and disease in
Canada has been growing, reducing quality of life,
increasing wait times for care, and challenging the
sustainability of the health system. And while chronic
disease remains the leading cause of death and
disability in Canada, up to two-thirds of the death and
disability that occur prematurely could be avoided. Health
promotion and risk reduction initiatives can play an
important role in reducing the impact of chronic disease.
Each person has factors that determine their risk of
chronic disease. Some of these, such as genetics, age
and gender, cannot be changed. However, up to 80
per cent of Canadians have at least one modifiable
risk factor such as unhealthy eating, unhealthy weight,
physical inactivity, or smoking which could be changed
to improve their health and reduce their risk of
chronic disease. Obesity is of particular concern:
about 65 per cent of men and 53 per cent of women
did not have healthy weights in 2004 and an estimated 26 per cent of children and youth between the
ages of 2 and 17 were either overweight or obese.
As the Canadian population ages and if obesity rates
continue to rise, increased rates of diabetes, cancer,
and cardiovascular disease can be expected. Without
focused and integrated action, these and other
chronic diseases will continue to place extraordinary
burdens on individual Canadians and on the
Canadian health care system.
The Agency supports the development of tools and
resources used by communities and professionals to
improve health and prevent and control chronic
disease. It facilitates collaboration, networking,
capacity building, and leadership in government-wide
efforts to advance action, with a view to building a
healthier nation, decreasing health disparities, and
contributing to the sustainability of the health care
system in Canada. Since its inception in 2004, the
Agency has had a positive impact on the growth of
chronic disease knowledge in Canada, and has
influenced a more cohesive and coordinated
approach to health promotion and chronic disease
control by decision-makers and health professionals.
Integrated Healthy Living and Chronic Disease
Strategy
A. Chronic Disease
WHAT WAS PLANNED
The Agency planned to implement the Integrated
Strategy on Healthy Living and Chronic Disease,
using the $300 million over five years announced in
September 2005, in collaboration with other members of the Health Portfolio, federal departments and
agencies, and a range of stakeholders. To do so, the
Agency planned to continue to develop and promote
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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41
policies and programs which would improve the
health of Canadians, reduce the impact of chronic
disease, and address the key determinants of health.
This included general and disease-specific approaches
to address conditions that lead to unhealthy eating,
physical inactivity and unhealthy weight; prevent
chronic disease through concerted action on major
chronic diseases and their risk factors; and support
early detection and management of chronic disease.
As part of this process, the Agency planned to:
n Continue to work with stakeholders and experts to
develop an Observatory of Best Practices which
would include a broad range of interventions at the
community level;
n Work with non-governmental organizations,
experts, and provinces/territories to implement
shared priorities in chronic disease surveillance,
including indicators on the nature and scope of
health problems, and factors to be addressed to
improve the health of the Canadian population; and
n Assess risk factors for chronic disease, including
behavioural, social and environmental factors, and
to continue to support the ongoing development of
health promotion and chronic disease prevention
and management interventions.
WHAT WAS ACHIEVED
All items planned in the 2006-07 were successfully
achieved.
The Agency launched the Canadian Best Practices
Portal for Health Promotion and Chronic Disease
Prevention in November 2006. Finding and using
best practices is a key part of delivering effective
initiatives. The Canadian Best Practices Portal (http://
cbpp-pcpe.phac-aspc.gc.ca) provides an array of
evidence-based best practices in health promotion
and chronic disease prevention. The Portal supports
decision-makers in practice, policy and research
working at all levels across the country. Currently, the
Portal focuses on community interventions addressing
cardiovascular disease, cancer, diabetes and their key
risk factors as well as the promotion of healthy living.
Feedback from Portal users and participants at Portal
awareness sessions and live demos has been very
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PUBLIC HEALTH AGENCY OF CANADA
positive. The Portal received 12,200 unique visitors
from its launch on November 16, 2006 to July 17,
2007. Users regularly submit nominations for best
practices and suggestions regarding other resources
for posting on the portal.
Tracking trends and statistics related to chronic
disease in Canada supports policy makers and
researchers in making more informed and more
effective decisions about chronic disease prevention,
control, and management. The Agency expanded its
activities around the development of a national
approach to chronic disease surveillance, including:
n Consulting with national stakeholder advisory
groups to develop the Indicator Framework for
Surveillance of Chronic Diseases (including mental
illness, cardiovascular diseases, chronic respiratory
disease, and arthritis);
n Completing five pilot projects which used provincial/
territorial administrative databases (such as hospital
discharge and physician billing records) for surveillance of mental illness, asthma, chronic obstructive
pulmonary disorder, arthritis, and hypertension;
n Extending the Non-Communicable Diseases
Surveillance Infobase, an internet web surveillance
tool (http://www.cvdinfobase.ca) to include a
broader range of diseases, and adding a
component which enables analysis at the regional
level. This provides stakeholders across all
Canadian jurisdictions access to a larger statistical
database on chronic disease; and
n Establishing a Task Group on Surveillance of
Chronic Disease and Injury to focus on the gaps in
available data to report on chronic disease and its
determinants and the impact of policies, programs
and services on the population’s health.
The Agency provided grants for research on risk
factors for diabetes, including the numbers of
Canadians exposed to different types of risk factors.
By enhancing knowledge of the impact of dietary
factors, physical activity, and obesity not just on
diabetes, but also on cancer and cardiovascular
disease, such studies enable public health officials to
plan effective interventions.
Agency scientific expertise supported federal efforts
related to eating disorders and obesity, policy directions and priorities on food, health claims on food,
the development of nutritional indicators, and the
revision of Canadian growth monitoring standards.
Together, these efforts ensured that policies, programs,
information, and services related to monitoring and
assessment of risk factors were informed by domestic
and international policy and practices, and were
responsive to the needs and concerns of Canadians.
Also, the Agency collaborated with Health Canada on
the revised Canada’s Food Guide, which identified
the connection between healthy eating behaviours
(portion size, healthy choices) and decreased risk for
chronic disease.
The Agency published the report How Healthy are
Rural Canadians; An Assessment of their Health Status
and Health Determinants (http://www.phac-aspc.gc.
ca/publicat/rural06/index.html) examined differences
in health between rural and urban Canadians, and
explored disadvantages and disparities facing rural
communities in Canada. The Agency also released
The Human Face of Mental Health and Mental Illness
in Canada 2006 (http://www.phac-aspc.gc.ca/
publicat/human-humain06/index.html) raising awareness and increasing knowledge and understanding
about mental health and mental illness in Canada.
This is an update to a 2002 report, with new chapters
on mental health, problematic substance use,
gambling, and hospitalization.
The Agency continued the development of an
enhanced mental illness surveillance system. Pilot
projects were completed in five centres across the
country to develop case definitions for mental illness
to be used with provincial and territorial administrative databases. Work was undertaken with the
Canadian Psychological Association to develop an
Internet-based surveillance method to collect data
from psychologists in various clinical settings.
Contacts were made with companies that manage
disability programs and supplementary health benefits
to provide data on prescriptions for mental illness,
short and long-term disability claims for mental
illness, and services to psychologists.
Chronic Disease and Injury Prevention and
Control Expert Group
The Agency continued to provide the official federal
representation as well as secretariat, policy, technical,
and financial support to the Chronic Disease and Injury
Prevention and Control Expert Group of the Public
Health Network. This Expert Group is responsible for
providing strong leadership in chronic disease and
injury prevention and control through the development,
recommendation and implementation of national
policies, practices, guidelines and standards from a
federal, provincial and territorial context.
n Cardiovascular Disease
Eight in ten Canadians have at least one risk factor
(hypertension, smoking, stress, obesity, diabetes) for
cardiovascular disease, and one in ten have three or
more risk factors.
WHAT WAS PLANNED
In collaboration with other members of the Health
Portfolio, and with provinces, territories, and key
stakeholders, the Agency planned to work toward the
establishment of a pan-Canadian Cardiovascular
Disease Strategy and Action Plan.
WHAT WAS ACHIEVED
In October, 2006, the Minister of Health announced
funding to develop a heart health framework, and to
address hypertension and cardiovascular disease
surveillance in Canada. Development of the
Canadian Heart Health Strategy and Action Plan was
initiated, and common interest areas such as
strengthening information systems, prevention and
detection of major risk factors, timely access to care,
knowledge development and translation into practice,
intervention impacts and outcomes, and Aboriginal/
indigenous cardiovascular health were identified. The
Agency entered into a funding agreement that
enabled the Heart and Stroke Foundation of Canada
to provide administrative support to the Expert Group
developing the Strategy and Action Plan.
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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43
An Expert Advisory Committee on Hypertension was
established to provide scientific and expert advice to
the Chief Public Health Officer. Funding was provided
for a number of hypertension prevention and control
projects endorsed by the Committee as making
important contributions to heart health. To contribute
to better consistency in the reporting of hypertension,
the Agency completed several surveillance pilot
projects designed to further develop and clarify case
definitions.
n Diabetes
Approximately 2 million Canadians live with diabetes,
although as many as one third may not know they
have it. Rates of type 2 diabetes, which account for
approximately 90 per cent of all cases, increased by
27 per cent between 1994 and 2000. Evidence
shows that type 2 diabetes can be prevented or
delayed through lifestyle modification efforts to reduce
weight, eat healthy food, and be physically active.
WHAT WAS PLANNED
The Agency planned to advance action on the nonaboriginal elements of the renewed Canadian
Diabetes Strategy (http://www.phac-aspc.gc.ca/
ccdpc-cpcmc/diabetes-diabete/english/strategy/
index.html) by working with the Canadian Diabetes
Association, provinces, territories and other national
and international partners to maintain a coordinated
approach to diabetes which maximizes impact and
reduces duplication.
diabetes prevention among high risk populations;
supporting approaches to enable earlier detection
of type 2 diabetes; and decreasing complications
experienced by those living with type 1and type 2
diabetes;
n Through the Public Health Network, establishing
priorities with provincial and territorial members for
diabetes community-based programs;
n Expanding the National Diabetes Surveillance
System to track several conditions associated with
diabetes such as renal failure, amputation, and
cardiovascular disease, and increasing the
involvement of First Nations populations in tracking
Aboriginal diabetes data; and
n Approving and funding 52 projects with a wide
range of objectives, including: building community
capacity, knowledge, awareness, and education;
conducting diabetes risk assessment; identifying
and disseminating prevention and control
interventions; and piloting screening studies
among the general population and those at risk.
SUCCESS STORY
Primer to Action
An ongoing challenge in the field of health promotion
is to develop programs which address the needs of
marginalised populations and which consider barriers
WHAT WAS ACHIEVED
such as poverty and social isolation. With funding from
Ongoing commitments were made in the areas of
partnership development, diabetes prevention and
control, surveillance, research, community-based
programming, and national coordination. Activities
included:
the Agency’s Canadian Diabetes Strategy program, the
n Continuing to build partnerships with the Canadian
Diabetes Association, the Kidney Foundation of
Canada, the Canadian National Institute for the
Blind, the Juvenile Diabetes Research Foundation,
and Diabète Quebec. With these groups, the
following new directions and focus for the
Canadian Diabetes Strategy were established:
Primer to Action: Social Determinants of Health is a
44 |
PUBLIC HEALTH AGENCY OF CANADA
Ontario Chronic Disease Prevention Alliance
developed a document which will help public health
stakeholders develop more effective programs and
policies to address chronic disease.
resource to help health professionals, lay workers,
volunteers and activists explore how the social
determinants of health impact on chronic disease and
how they need to be considered in the design of
programs and policies.
n Cancer
Cancer is the leading cause of premature death in
Canada. In 2007, the number of new cases is
estimated to be 159,900 and the number of deaths
to be 72,700. This is an additional 6,800 new cases
over the estimate for 2006.
WHAT WAS PLANNED
The Agency planned to lead the implementation of
the Canadian Strategy for Cancer Control (CSCC)
(http://www.cancer.ca/ccs/internet/standard/
0,3182,3172_335265__langId-en,00.html) to help
improve cancer screening, prevention and research
activities, and to help coordinate efforts with provinces, territories and cancer care advocacy groups.
The CSCC’s main objectives are to: reduce the
number of new cases of cancer among Canadians;
enhance the quality of life of those living with the
disease; and lessen the likelihood of Canadians dying
from cancer.
Other planned cancer activities included
collaborating with stakeholders to address breast
cancer issues ranging from prevention to palliative
care through the Canadian Breast Cancer Initiative
examining the implications of childhood cancer on
Canada’s health care system, and addressing
knowledge gaps through the Canadian Childhood
Cancer Surveillance and Control Program.
WHAT WAS ACHIEVED
The Agency was a key stakeholder in the development
of the Canadian Strategy for Cancer Control (CSCC)
and provided secretariat support to the CSCC’s
Action Groups. In November 2006, the Prime
Minister announced the creation of the Canadian
Partnership Against Cancer (CPAC), an arms length,
not-for-profit entity that would be responsible for
implementation of the CSCC. The Agency continued
to support the work of the Action Groups and
facilitated the transition of responsibility for the CSCC
to the new entity. As part of this transition the Agency
provided funding to enable the National Aboriginal
Organizations to develop their capacity to participate
in the CSCC.
The Agency contributed substantially to the
publication of Canadian Cancer Statistics 2007 in
collaboration with the Canadian Cancer Society and
Statistics Canada. It provides current information on
cancer incidence and mortality, and monitors cancer
trends. Cancer in Young Adults, published jointly by
Cancer Care Ontario and the Agency, reported on
issues related to the exposure of young adults to
carcinogens. These knowledge-building reports were
developed to stimulate research, assist decisionmaking, and contribute to health care planning.
The Agency developed and delivered provincial
training modules related to the collection of cancer
stage information for breast, prostate, colorectal,
lung, head and neck cancers in provincial/territorial
cancer registries. The training helped to increase
reporting consistency across the country, led to a
more accurate national picture regarding the stages
of cancer, and contributed to increased provincial
cancer registry staging capacity.
Wait times, quality of life, and use of health care
services are priorities in Canadian health care
planning. With collaborators, the Agency initiated and
completed studies examining these topics in relation
to children and adolescents with cancer.
While continuing to fund breast cancer projects, the
Agency consulted with key stakeholders in the breast
cancer community to ensure the ongoing relevancy,
timeliness, and effectiveness of its community
capacity-building activities. This process was integral
to understanding the needs of the community-based
organizations which provide breast cancer detection
and management services to Canadians. To
determine programming needs, the Agency gathered
and assessed information on community needs and
priorities for outreach support for diverse populations,
developed sustaining partnerships for networks and
coalitions, and coordinated information needs for
those with advanced breast cancer.
The Canadian Breast Cancer Research Alliance
(CBCRA), the largest portion of the Canadian Breast
Cancer Initiative, successfully undertook an
independent evaluation. The study, which was
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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45
supplemented by an External Review Panel, was very
positive about CBCRA’s achievements.
International Non-Communicable Disease Policy
On the international front, the Agency houses the
WHO Collaborating Centre on Non-Communicable
(Chronic) Disease Policy (WHOCC), under the
scientific leadership of the Deputy Chief Public Health
Officer. As the only collaborating centre on noncommunicable disease (NCD) policy in the Americas
and Europe, the Agency’s WHO Collaborating
Centre has become a global centre of excellence in
the analysis of chronic disease policy development
and implementation.
The WHOCC was also co-leading, with the Pan
American Health Organization, in the development of
the Policy Observatory of Non-Communicable
Diseases. The purpose of the observatory is to support
more effective NCD related policy formulation and
implementation and to create strong international and
multisectoral collaboration in NCD prevention on
policy development and implementation. Over the
past year, the observatory boosted the technical
capacity of policy analysis in a number of countries of
the Americas such as Costa Rica and Brazil, and in
European countries such as Russia, Slovenia and
Spain.
The WHOCC, through the Deputy Chief Public
Health Officer, coordinates an international policy
working group on non-communicable disease policy.
In this regard, over the last year, it has provided
technical support to the development of the European
Regional Strategy and action plan on chronic disease
as well as the PAHO regional action plan on chronic
disease. It has also supported the development of
policy consultations and case studies on chronic
disease in a number of countries in Europe and in the
Americas that are participating in the WHO regional
network for chronic diseases such as the Conjunto do
Acciones para la Reduccion Multifactorial de las
Enfermedades No Tranmisibles (CARMEN) and the
Countrywide Integrated Non-communicable Disease
Intervention (CINDI).
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PUBLIC HEALTH AGENCY OF CANADA
WHOCC has played an integral role in the
development and signing of a Framework for
Cooperation on Chronic Diseases between the WHO
and Canada, the objective being to promote joint
actions aimed at strengthening the global response to
chronic disease. The areas of cooperation were:
policy development and evaluation, development and
dissemination of best practices; implementation of the
Global Strategy on Diet, Physical Activity and Health;
Cancer prevention and control.
B. Healthy Living Strategies
Research has demonstrated that physical activity and
healthy eating play a key role in improving health and
preventing disease, disability and premature death.
However, physical inactivity and unhealthy eating
among Canadians have continued to rise, as have
rates of obesity. Obesity exacerbates nearly all
physical chronic conditions, significantly contributes to
the incidence of chronic disease complications and
can adversely affect mental health. By working
collaboratively with partners and other levels of
government, the Agency is committed to policies to
improve the opportunities in physical activity and
healthy eating and to help make healthy choices
easier for all Canadians.
WHAT WAS PLANNED
In 2006-07, the Agency planned to work across the
Health Portfolio, with other federal departments and
agencies and in collaboration with a range of
stakeholders to promote the health of Canadians by
addressing the conditions that lead to unhealthy
eating, physical inactivity and unhealthy weight by
means of the following activities:
n Providing funding support to the voluntary sector to
develop and exchange knowledge, and build
capacity at regional, national and international
levels;
n Participating in the Joint Consortium for School
Health to promote the health of children and youth
in school settings;
n Fostering collaboration and improved information
exchange among sectors and across jurisdictions
through the Intersectoral Healthy Living Network.
WHAT WAS ACHIEVED
In 2006-07, the Agency continued to advance its
health promotion agenda in the area of healthy living
through a range of initiatives:
n The Children’s Fitness Tax Credit (CFTC), which
came into effect on January 1, 2007, establishes
economic conditions that support regular physical
activity. The Agency participated in a print and web
advertising campaign which informed Canadians
about the new CFTC, and promoted participation
in physical activity and sport for children and
youth.
n In 2006, the Agency announced renewed federal
support to ParticipACTION, which will undertake
marketing and communications activities to help
advance federal communications objectives
around physical activity and healthy eating.
Canadian Heritage (Sport Canada) is also
providing federal support to ParticipACTION.
n The Agency contributed funding to 14 nongovernmental organizations to undertake
enhanced evaluations of their initiatives to ensure
that the programs are having the desired impact.
The enhanced evaluations included activities such
as evaluating basic performance data associated
with the individual initiatives; identifying best
practices for healthy living interventions; measuring
changes in awareness and understanding of the
relationship between physical activity and healthy
growth and development, as well as uptake and
on-going use of resources; and, identifying and
measuring effective means for disseminating
evidence-based research associated with physical
activity, with the goal of developing user-friendly
resources for use by grassroots practitioners and
organizations.
n In 2006, the Agency also developed a framework
for creating Bilateral Agreements on Physical
Activity and Healthy Eating with provincial and
territorial governments based on activities of
mutual interest.
n Through the Canadian Fitness and Lifestyle
Research Institute (CFLRI) (www.cflri.ca), the
Agency supported the Physical Activity Benchmarks
Program, which monitors changes in physical
activity within the population, as well as the
Institute’s analysis of the Canadian Community
Health Survey, which contains physical activity
questions.
n Through Canada’s Physical Activity Guide to
Healthy Active Living (http://www.phac-aspc.gc.ca/
pau-uap/paguide/), the Agency continued to
disseminate and promote national physical activity
guidelines aimed at children, youth, adults, and
older adults. Between April 2006 and March
2007, 2,751,446 copies of the Guides and
related resources were distributed to Canadians
and abroad.
n The Agency also partnered with the provinces
and territories to deliver SummerActive
(www.summeractive.org/en/) and WinterActive
annual seasonal initiatives that raise awareness of
how Canadians can take their first steps to
improving their health and mobilize community
actions that focus on local opportunities for
physical activity, healthy eating and other healthy
behaviours.
n The Agency participated in various working groups
which oversaw health survey development,
including the Canadian Community Health Survey,
to ensure that surveys continued to maintain and
develop content relevant to physical activity
surveillance.
n The Agency created and executed a successful
advertising campaign aimed at promoting a
healthy lifestyle before and during pregnancy.
Launched in February 2007, the campaign
targeted women 18 to 29 years old and relied on
out-of-home advertising tactics: posters in public
transit, doctor’s offices, bars and restaurants, as
well as internet banners. The advertisements
encouraged women to seek more information on
healthy pregnancy by calling 1 800 O-Canada or
by visiting www.healthycanadians.ca—a single
gateway to a variety of authoritative information on
the subject. Although the campaign ran for only
6 weeks, according to survey results, it reached a
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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47
substantial 28 per cent of the targeted audience.
As part of the campaign, the Agency also created
and distributed in print and electronic versions
230,000 copies of the Sensible Guide to a Healthy
Pregnancy.
The Agency is responsible for co-chairing and
providing secretariat support to the Healthy Living
Issue Group (HLIG) which reports to the Council of
the Public Health Network (Federal/Provincial/
Territorial) through the Population Health Promotion
Expert Group (to which the Agency also provides
policy and secretariat support). The HLIG is tasked
with reporting on progress in meeting the targets and
outcomes contained in the Pan-Canadian Healthy
Living Strategy. Both an Evaluation Working Group
and a Disparities Working Group were struck in 2006
to support the work of the Issue Group.
The Issue Group continues to provide leadership for
the Intersectoral Healthy Living Network and ensures
that the purpose and guiding principles of the PanCanadian Healthy Living Strategy are upheld. The
Intersectoral Healthy Living Network acts as a virtual
network to bring together key players across sectors
and jurisdictions on activities related to healthy living
in order to advance the Pan-Canadian Healthy Living
Strategy.
Through its association with the Joint Consortium for
School Health (JCSH), the Agency continued to
promote healthy eating and physical activity in the
school setting. The JCSH provides leadership and
facilitates a coordinated approach to school health by
encouraging collaboration between the health and
education sectors. In 2006-07, the JCSH developed
draft knowledge summaries and quick scans on
physical activity and nutrition to share with member
provinces and territories. In addition, two national
events took place: a National Conference on School
Health and a national meeting on data and
monitoring to discuss the need for regular, reliable
and timely information for schools relating to
programs, policies and the health of school-aged
children.
PROMOTING PUBLIC HEALTH AND PREVENTION
Affiliation of Multicultural Societies and Service
Agencies
One of the ways the Agency supports prevention program
The Promoting Healthy Living in BC’s Multicultural
across the country is to facilitate effective evaluation and
Communities project was initiated and funded by the
research processes with partner organizations. Some
Agency to identify the public health needs and health
successful examples of these include the following:
status of multicultural communities. The project created
SUCCESS STORIES – PARTNERSHIP INITIATIVES
Supporting Evaluation of Nutrition Programs
The Agency’s Alberta/Northwest Territories Region
provided funding to Dietitians of Canada to review and
compile a collection of reliable nutrition assessment and
knowledge assessment instruments. This project will
increase community practitioners’ access to high quality
data collection instruments that can be used in measuring
the impact of projects on nutrition knowledge and
behaviours (e.g. food intake). The results of this project
will be disseminated to evaluation networks in the
Agency, other chronic disease related networks and to
the Agency-funded projects.
tools, resources and directories to facilitate access to
health information and services for these communities.
Multicultural health fairs were held to bring professionals
and members of public together to share and benefit
from each other’s resources and information on
multicultural health. The project has partnerships with
Provincial Ministries and health authorities; municipal
governments; the private sector and numerous NonGovernmental Organizations. As a result of this project,
Agencies in British Columbia will be better able to
understand the health issues of the various cultural
communities in this province and to develop more
effective programs and policies. www.amssa.org/
multiculturalhealthyliving/
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PUBLIC HEALTH AGENCY OF CANADA
Other Health Promotion Initiatives
n Children and Adolescents
WHAT WAS PLANNED
The Agency planned to continue to provide
leadership, contribute to knowledge development and
exchange, and implement community-based
programs through the following activities:
n Continuing to deliver a wide range of communitybased programs for women, children, and families;
n Contributing to the implementation of the United
Nations Convention on the Rights of the Child
throughout the Americas; and
n Developing and exchanging knowledge on the
health of children and adolescents.
WHAT WAS ACHIEVED
In 2006-07, the Public Health Agency of Canada
continued to successfully deliver health promotion
programming to pregnant women, children and
families at risk for poor health outcomes through
three community-based programs:
n Through the Community Action Program for
Children (CAPC), the Agency provided funding for
community groups to deliver health promotion
programs for at-risk children who are up to 6 years
old;
n Through the Canada Prenatal Nutrition Program
(CPNP), the Agency funded community agencies to
increase access to health services and supports
pregnant women living in conditions of risk. It
served about 50,000 women, reaching an
estimated 60% of low income pregnant women,
37% of pregnant Aboriginal women, and 40% of
teenage mothers delivering live births in Canada.
n Through its Aboriginal Head Start in Urban and
Northern Communities program the Agency
continued to fund local Aboriginal organizations to
provide health promotion programs for off-reserve
children up to age 6.
On behalf of the Minister of Health, the Agency
continued to co-lead with the Department of Justice,
federal government work on matters concerning the
United Nations Convention on the Rights of the Child.
Through its collaboration with the Inter-American
Children’s Institute – a special institute of the Organization of American States – the Agency contributed to
the implementation of the Convention throughout the
Americas.
Through the Centres of Excellence for Children’s
Well-Being initiative, the Agency continued to
generate and disseminate the latest knowledge on
children’s well-being to a broad network of target
audiences, including families, service providers,
community groups and policy-makers. The Agency
developed practical health promotion tools and
provided advice to all levels of government and
international organizations on the issues of early
childhood development, special needs, youth
engagement and child welfare to strengthen childrelated policies and programs in Canada and
abroad.
The Agency’s Health Behaviours of School-aged
Children (HBSC) survey continued to contribute to the
development of knowledge concerning the health and
health behaviours of Canada’s youth. It is the only
national health promotion database for this age
range in Canada.
In addition, the Agency’s Fetal Alcohol Spectrum
Disorder (FASD) initiative continued to develop and
provide access to culturally appropriate knowledge
for decision-making, as well as tools, resources, and
expertise across the country. The program focuses on
the prevention of future births affected by alcohol,
and the improvement of outcomes for those
individuals and families already affected, through:
increasing public and professional capacity;
developing capacities; creating effective screening,
diagnosis and data reporting; expanding the
knowledge base and information exchange; and
increasing commitment to FASD reduction.
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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49
SUCCESS STORIES
Projects Promoting the Health of Children
In 2006-07, the Agency’s Quebec Region developed a
receives financial support from the Agency’s Quebec
bilingual online training module to promote child health
Region office, targets school aged children. In 2006-07,
and help prevent Fetal Alcohol Spectrum Disorder
the project developed an Internet education program for
(FASD). Designed as accredited training, this professional
primary and secondary level pupils on healthy living
development module provides physicians with resources
habits and diabetes. The project also developed and
to assist them in addressing the issue of alcohol use
produced materials for a large media campaign
among women of childbearing age. Module objectives
addressing Quebec’s English-speaking minority language
are to facilitate participants’ understanding of the
communities, including the Aboriginal communities, most
consequences of fetal alcohol exposure and develop skill
of whom lie in rural, remote or northern settings. All of
in assessing alcohol consumption in women before and
the tools developed by the project have been tested,
during pregnancy. Memorial University in Newfoundland
assessed and translated for the three cycles of primary
has established a partnership with Laval University in
school. The project is receiving special attention from
Quebec City for category 1 accreditation to encourage
education and health circles in connection with the Écoles
Quebec physicians to take part in the program.
en santé (healthy schools) program under the Quebec
The Quebec Heart and Stroke Foundation’s En route, en
Department of Education.
coeur (On the Road to a Happy Heart) project, which
Aging and Seniors
WHAT WAS PLANNED
The Agency planned to continue providing leadership
on healthy aging through policy development, health
promotion, research and education, partnerships and
dissemination of information.
WHAT WAS ACHIEVED
Canadian and global events have demonstrated the
special risks faced by seniors as a vulnerable
population during catastrophic events. The Agency
organized the Winnipeg International Workshop on
Seniors and Emergency Preparedness on February 69, 2007. More than 100 gerontology, emergency
preparedness and health promotion experts from nine
countries participated and planned future
collaborative action. The workshop served to integrate
seniors more fully into emergency preparedness
policies and practices, and opened an important
dialogue among experts, including seniors, to achieve
a common understanding of the impacts of disasters
on older people and the actions required to take their
needs and potential contributions to the recovery of
their communities into account. The Agency was
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PUBLIC HEALTH AGENCY OF CANADA
presented with an international award for related
efforts by Queen Elizabeth II in May 2006.
At this conference the Minister of Health announced
financial support for a project from the World Health
Organization titled Seniors in Emergencies: Engaging
in Humanitarian Action. The funding will help further
support international readiness in meeting the needs
of seniors in emergency situations.
Also in collaboration with WHO, the Agency
supported research on Age Friendly Cities in 32 cities
around the world, four of which are in Canada
(Saanich, British Columbia; Portage La Prairie,
Manitoba; Sherbrooke, Québec; and Halifax, Nova
Scotia). The Agency also initiated similar research with
eight provinces in ten small rural communities (Alert
Bay, British Columbia, Lumby, British Columbia, High
Prairie, Alberta, Turtleford, Saskatchewan, Gimli,
Manitoba, Township of Bonnechere Valley, Ontario,
Town of Guysborough, Nova Scotia, Alberton, Prince
Edward Island, Clarenville, Newfoundland and
Labrador, Port Hope Simpson, Newfoundland and
Labrador.
Mental Health
WHAT WAS ACHIEVED
WHAT WAS PLANNED
The Agency planned to continue advancing mental
health issues across government.
WHAT WAS ACHIEVED
In 2006-07, the Agency supported the work of the
Interdepartmental Task Force on Mental Health to
identify ways to improve the mental health status of
those populations that fall within federal jurisdiction.
The Agency also responded to the Kirby Senate
Committee’s final report Out of the Shadows at Last:
Transforming Mental Health, Mental Illness, and
Addiction Services in Canada published in May 2006.
In addition, the Agency continued to provide
secretariat support to the Federal/Provincial-Territorial
Advisory Network on Mental Health (ANMH) which
provides an inter-governmental forum for national
collaboration and intersectoral action on mental
health and mental illness.
Family Violence
WHAT WAS PLANNED
In 2006-07, the Agency planned to continue playing
a central role in increasing awareness and advancing
knowledge in the area of family violence.
WHAT WAS ACHIEVED
The Agency was responsible for leading and
coordinating the Family Violence Initiative and for
managing the National Clearinghouse on Family
Violence on behalf of 15 federal departments, Crown
corporations and agencies (http://www.phacaspc.gc.ca/ncfv-cnivf/familyviolence). The Initiative
strengthens the criminal justice, housing and health
systems’ response to family violence; promotes public
awareness of the risk factors of family violence and
the need for public involvement; and supports data
collection, research and evaluation efforts.
Canadian Health Network
WHAT WAS PLANNED
The Agency planned to continue to providing the
Canadian Health Network – a key information service
which supports the Agency’s work in helping to build
healthy communities.
The Agency continued to fund 20 major Canadian
health organizations to deliver the Canadian Health
Network (CHN) program, resulting in sustained
growth in reach and network size. As of March 31,
2007, there were more than 69,000 subscribers to
the newsletter (HealthLink / Bulletin santé) compared
to less than 27,000 one year prior. A total number of
3,106,870 visitors accessed the CHN website in
2006-07.
Additional Health Promotion Activities
Other health promotion activities during 2006-07
included:
n Building on the success of its 2005-06 Healthy
Lunches to Go pilot project, the Agency relaunched the social marketing project in January
2007 to correspond with the new 2007 Canada
Food Guide, and included updated interactive
tools, such as a webcast and daily nutrition tips
sent by email or text message.
n Providing funding for the Canadian Fitness and
Lifestyle Research Institute, a national nongovernmental organization, for their efforts on the
Benchmarks program. This information and
analysis tool has been monitoring physical activity
in Canada for a number of years. The program is
also an example of federal-provincial/territorial
partnership and collaboration.
n Negotiating Bilateral Agreements on physical
activity and healthy eating with each of the
provinces and territories. The Agreements will aim
to reduce health disparities by focusing on
vulnerable populations and related settings for
action, and will reflect joint priorities between the
federal and provincial/territorial governments.
Along with joint priorities, the Agreements will
include matched funding between the federal
government and the province/territory.
n Playing a strategic role in the development of the
World Health Organization (WHO) School Policy
Framework, an important component of the WHO
Global Strategy on Diet, Physical Activity, and
Health. The Policy Framework will guide primarily
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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51
Public Health Tools and Practice
policy makers in the development and implementation of policies that promote healthy eating and
physical activity in the school setting through
environmental, behaviour and education changes.
A strong public health system requires a deep, crossjurisdictional human resources capacity, effective
dissemination of knowledge and information systems,
and a public health law and policy system that evolves
in response to changes in public needs and expectations. The Agency’s contributes to all these areas
through the following key initiatives:
n The Agency began to explore the feasibility of
initiating consultations as the first step towards
potentially establishing a national surveillance
system for autism.
Building Public Health Human Resource Capacity
Planned ($M)
Authorities ($M)
Actual ($M)
10.9
10.8
10.4
WHAT WAS PLANNED
In 2006-07 the Agency intended to:
n support the Public Health Human Resource Task
Group of the Pan-Canadian Public Health Network
in steps to develop a Pan-Canadian Framework for
Public Health Human Resources Planning;
n hold consultations with experts across Canada
about public health competency profiles;
n work with partners to develop databases on public
health human resources;
n significantly increase the number of placements
available in the Canadian Field Epidemiology
Program;
n add and/or improve the Skills Enhancement for
Public Health program modules;
n provide training awards to promote education in
applied public health;
n collaboratively with universities develop guidelines
for applied public health masters programs; and
n prepare a comprehensive professional
development plan for its staff.
WHAT WAS ACHIEVED
In 2006-07, the Agency continued to support the
Public Health Human Resource Task Group of the
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PUBLIC HEALTH AGENCY OF CANADA
Pan-Canadian Public Health Network. An Enumeration Working Group was formed to adress the
limitations of public health workforce data reported at
the regional, provincial, and national levels. Stakeholders including jurisdictions, disciplines, national
data agencies, and federal partners agreed in
principle to jointly work with the Agency and the Task
Group to address these limitations.
Clear statements of core competencies for public
health will enable Canadian jurisdictions to strengthen
the public health workforce. In 2006-07, the Agency
began to conduct consultations on these core
competencies. Activities included an online survey,
which had 1,606 respondents from across Canada.
Regional consultations held with the public health
community in British Columbia, Alberta, Saskatchewan and Manitoba helped to identify opportunities,
challenges, and strategies for implementation; and
identify roles and responsibilities. Work with public
health discipline groups including nurses, health
inspectors/environmental health officers, epidemiologists, medical officers, dentists/dental hygienists,
nutritionists/dieticians and health promoters/educators
helped to focus on discipline-specific competencies.
In addition to expanding the intake from 13 in 200506 to 15 in 2006-07 the Canadian Field Epidemiology Program (CFEP) (http://www.phac-aspc.gc.ca/
cfep-pcet/index.html) increased its offering of external
successful Doctoral Research and Fellowship applicants, and to fund 20 universities for Master’s in
Public Health programs.
seats for public health practitioners in its training
modules. The program also successfully piloted a
new module on Rapid Assessment for Complex
Emergencies.
To address the learning needs of front-line public
health practitioners the Agency launched two
modules – Introduction to Public Health Surveillance
and Applied Epidemiology: Injuries – bringing the
number of modules in the Skills Enhancement for
Public Health program to seven. Other new modules
including Communicating Data Effectively, Basic
Biostatistics, and Principles & Practices of Public
Health, were piloted. Registration increased as new
modules were added and awareness of the program
grew – a total of 1,456 participants completed at
least 1 module in 2006-07. Also, thirty additional
online facilitators were trained to further build capacity.
The Agency partnered with Canadian Institutes of
Health Research (CIHR) to provide grants to fifteen
To prepare a comprehensive professional development plan for its staff, a working group was formed to
look at training needed to support public health practice done by the Agency. Through interviews and focus
groups, training needs were identified for key professional groups. The Agency created a pilot Public Health
Practice Learning Calendar offering competency
based training and education to staff. An intranet site,
Learning @PHAC, was launched to consolidate
learning and training resources at the Agency.
In summary, the Agency accomplished all activities
planned for Building Public Health Human Resource
Capacity in the 2006-07 Report on Plans and
Priorities with the exception of developing databases
on public health human resources.
Knowledge and Information Systems
Planned ($M)
Authorities ($M)
Actual ($M)
6.1
15.1*
15.1
* The difference between planned and authorities reflects the funding received for the National Collaborating Centres
Contribution Program.
WHAT WAS PLANNED
WHAT WAS ACHIEVED
The Agency planned to:
All these plans were fulfilled as the Agency develop
information about public health knowledge and
information systems, to increase and exchange
knowledge in this area, and to leverage the
information and knowledge into effective action.
n keep the integrated Public Health Information
System (iPHIS),in a pandemic-ready state, with new
modules for outbreak management;
n work towards a seamless transition for users when
the Infoway solution becomes available;
n promote the Public Health Map Generator
(PHMG); and
n undertake the groundwork leading to the development of an annual report on the state of the
public’s health.
The Agency continued to maintain and support the
iPHIS product, and made the Outbreak Management
module available to jurisdictions across Canada. The
Agency also worked to investigate a data migration
strategy for iPHIS-deployed jurisdictions to the
planned successor (Infoway Panorama) solution.
Throughout 2006-07 the Agency provided expert
resources to the Infoway Electronic Public Health
System (now known as Panorama) project. By participating in forums including Design working groups, Pan-
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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53
Canadian Standards Group, Implementation Working
Group, Steering Committee, Product Management
Committee, Joint Implementation Leads, the Agency
transferred the knowledge gained by past work in the
development of case management tools usage by
federal, provincial, and territorial officials.
As of March 2007, the Agency’s GIS Infrastructure
(http://www.phac-aspc.gc.ca/php-psp/gis_e.html)
tools, data, services and training supported 361
public health professionals (“clients”) from 141 public
health organizations across Canada. All 361 clients
were members of the online GIS community known as
the Map and Data Exchange. The Agency continued
to support a variety of initiatives across Canada
through the provision of data and spatial services.
The Public Health Agency of Canada Act mandates
the Chief Public Health Officer to submit a report to
parliament on the State of Public Health in Canada,
with the first Report to be tabled by or before January
2008. During 2006-07, the Agency established working groups responsible for consultations, compilation
of information for the Report, and provision of tech-
Surveillance and Information Expert Group
The Agency continued to provide the official
federal representation as well as secretariat,
policy, technical, and financial support to the
Surveillance and Information Expert Group of the
Public Health Network. This Expert Group is
responsible for providing coordination and
leadership for public health surveillance,
information collection, analysis and sharing, and
knowledge dissemination across Canada from a
federal, provincial and territorial context.
nical advice. The Agency hosted consultative meetings
on Storyline Development, Lessons Learned and
Health Inequalities, with internal and external stakeholders. Background research, framing exercises and
content development were initiated and extensive
stakeholder consultations were undertaken.
All six of the Agency-funded National Collaborating
Centres (NCCs) for Public Health were in place:
NCC focus
Location
Environmental health
BC Centre for Disease Control, Vancouver
Aboriginal health
University of Northern British Columbia, Prince George
Infectious diseases
International Centre for Infectious Diseases, Winnipeg
Public health methods and tools
McMaster University, Hamilton
Healthy public policy
Institut national de santé publique du Québec, Montréal
Determinants of health
St. Francis Xavier University, Antigonish
The NCCs connected with public health policy-makers,
researchers and practitioners through environmental
scans of stakeholders in their respective priority areas,
and participated in educational and research fora to
determine the knowledge needs of frontline public
health practitioners, identify knowledge gaps, and
develop knowledge communities. The NCCs collaborated with each other and external partners to
54 |
PUBLIC HEALTH AGENCY OF CANADA
synthesize existing research, develop reports and tools
for their user groups, and develop knowledge transfer
approaches through participation in events such as
Annual Canadian Public Health Conference and the
5th Annual Cochrane Symposium. As part of their
mandate of transferring knowledge among public
health stakeholders, the NCCs will hold their 2nd
Annual Summer Institute in Nova Scotia, August 2007.
Public Health Law and Information Policy
Planned ($M)
Authorities ($M)
Actual ($M)
3.3
3.3
3.2
WHAT WAS PLANNED
Expert reports from the Naylor Commission (Learning
from SARS: Renewal of Public Health in Canada) and
the Kirby Commission (Reforming Health Protection
and Promotion in Canada: Time to Act) urged
federal, provincial and territorial stakeholders to
collaborate on the development of agreements that
would provide for effective surveillance through
common standards and practices for information
sharing and public health responses.
During 2006-07 the Agency planned to continue to
take an active role with its provincial and territorial
partners in harmonizing legislation and developing
and implementing policies, practices and mechanisms
that comply with privacy rights yet allow better
collection, use and sharing of key health information
for the prevention and control of communicable
diseases and health emergencies.
The International Health Regulations, adopted in
2005, outlined the need for a strong legal foundation
for public health practice at all levels of government.
Having this in place is crucial for Canada’s capacity
to respond to new and re-emerging public health
threats. To address this, the Agency planned to
undertake activities such as specialized workshops
and discussions for the dissemination of targeted
research and analysis in public health law.
WHAT WAS ACHIEVED
policies, increased and exchanged knowledge in this
area, and leveraged the information and knowledge
into effective action.
In November 2006, the Agency played a major role
in delivering the first Canadian Conference on the
Public’s Health and the Law, which brought together
some of the most respected Canadian and
international public health law expertise to review
progress and consider future challenges including
planning for Pandemics. The conference strengthened
public health capacity by promoting an enhanced
understanding of the application of various legal and
policy instruments in public health, and by fostering
professional linkages across disciplines.
The Agency held specialized workshops and discussions with key provincial, territorial and international
agencies and stakeholders to collaborate on common
challenges, identify common problems and disseminate the results of targeted research and analysis in
public health law. The Agency also collaborated with
leading researchers in public health law and shared
the results of this research through the Public Health
Law Improvement Network.
The Agency took an active role in enhancing the
integration of ethical considerations into public health
decision-making by collaborating and taking the first
steps to facilitate a National Roundtable on Public
Health and Ethics.
These plans were completed. The Agency developed
information about public health law, and information
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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55
Strategic and Developmental Initiatives
Planned ($M)
Authorities ($M)
Actual ($M)
12.9
12.8
12.3*
* Actual spending was $0.5 million lower than authorities due to capacity and technical constraints.
The Public Health Agency of Canada recognizes that
strategic and developmental initiatives are required to
support the achievement of its priorities and advance
the work of improving public health.
WHAT WAS ACHIEVED
All the planned initiatives were undertaken.
n in collaboration with other organizations including
the Canadian Institute for Health Information
(CIHI), to continue to deliver crucial surveillance
programs;
Health surveillance supports disease prevention, and
enables public health professionals to manage outbreaks and threats. Public Health Surveillance – the
ongoing, systematic use of routinely-collected health
data to guide public health actions – has been identified as a priority area for the Agency in its Strategic
Plan, and a senior multidisciplinary task group was
launched during March 2007 to begin the review of
the Agency’s surveillance infrastructure components.
n continue to support the Pan-Canadian Public
Health Network, including establishment of
intersectoral working groups in priority areas, and
continued development of agreements for sharing
of information, facilities, and personnel during
health emergencies;
The Agency continued to provide key surveillance
programs during 2006-07. In collaboration with the
Canadian Institute for Health Information and the
Canadian Population Health Initiative and many other
organizations, the Agency delivered surveillance
programs including:
n to develop a profile of the public health
environment in Canada, in preparation for
collaborative development of a Pan-Canadian
Public Health Strategy;
n Canadian Creutzfeldt-Jakob Disease Surveillance
System (CJDSS)
WHAT WAS PLANNED
The Agency intended:
n to collaborate with Health Canada to further
strengthen partnership with the World Health
Organization in support of the WHO’s new
Commission on the Social Determinants of Health
(SDOH);
n to coordinate the establishment of a Health
Portfolio plan with Health Canada and the
Canadian Institutes for Health Research to advance
an intersectoral federal government approach; and
n to continue to develop an international strategic
framework for coherence of efforts, and to expand
the Agency’s capacity for international policy
development and global partnerships.
n Canadian Hospitals Injury Reporting and
Prevention Program (CHIRPP)
n Canadian Integrated Program for Antimicrobial
Resistance Surveillance (CIPARS)
n Canadian Laboratory Surveillance Network
(PulseNet and other DNA fingerprinting outbreak
surveillance systems)
n Canadian Nosocomial Infection Surveillance
Program (CNISP)
n Canadian Nosocomial Infection Surveillance
Program (CNISP)
n Canadian Tuberculosis Laboratory Surveillance
System (CTBLSS/GRID)
n HIV/AIDS Surveillance program
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PUBLIC HEALTH AGENCY OF CANADA
n National Diabetes Surveillance System (NDSS)
n National Enteric Surveillance Program (NESP)
n National West Nile Virus Surveillance program
n Surveillance of Vaccine Escape mutants of
Meningococci, H. influenzae and B. pertussis
The Agency continued to represent the Federal
government in the Pan-Canadian Public Health
Network and to provide secretariat, policy, technical,
and financial support to it. The Network, whose
creation was announced by the Federal-ProvincialTerritorial Ministers of Health in April, 2005, was
established to provide a new, more collaborative
approach to public health. Improved communication
and collaboration, particularly critical during public
health emergencies such as SARS or pandemic
influenza, will also assist Canada in addressing
serious public health issues such as obesity and noncommunicable disease.
The Agency’s Chief Public Health Officer is the
federal co-chair of the Public Health Network’s
governing Council. In addition, Agency personnel
represent the federal government on each of the
groups reporting to the Network.
In 2006-07 the Public Health Network focussed on
three key areas:
n Preparing for and responding to emergencies and
communicable disease control and prevention;
n Building public health infrastructure and
organization; and
n Promoting health and healthy living.
The Public Health Network has proven to be a key
mechanism for collaboration between federal,
provincial and territorial governments, and an
effective vehicle for advancing a Canadian public
health agenda. Progress made during 2006-07
included:
n Agreement on recommended size, composition
and use of the national antivirals stockpile to
provide for early treatment of those with pandemic
influenza;
n Release of the 2006 Canadian Pandemic Influenza
Plan for the Health Sector;
n Analysis and refinement of the Network’s
organizational structure to provide greater
precision on the mandate and authority of the
Public Health Network, resulting in improved
linkages between groups within the Public Health
Network and increased operational efficiency.
In addition, significant progress was made on
development of joint agreements respecting roles and
responsibilities in pandemic preparedness and
response, information sharing, and the sharing of
resources, facilities and personnel.
Actions to create a foundation for the development of
a Pan-Canadian Public Health Strategy, to be
overseen by the Pan-Canadian Public Health
Network, included strengthening the policy base in
the Agency’s regions to contribute to the intelligence
cycle. The expanded regional work of gathering,
analyzing and providing advice on public health
information within the provincial and territorial
jurisdictions allowed the Agency to develop an
emerging profile and understanding of the public
health environment in Canada, and contributed to the
Agency’s ability to identify current initiatives, gaps,
and vulnerabilities.
The Agency strengthened its partnership with the
World Health Organization (WHO) Commission on
Social Determinants of Health through contributing
knowledge and expertise that helped to shape the
direction and recommendations to be contained in its
Interim Statement and Final Report, and also by
funding two Knowledge Networks to synthesize global
evidence for policy and action. Further, the Agency
collaborated with the Commission on the planning of
the 8th WHO Commission meeting (to be held in
Canada). The Agency contributed to Canada’s
leadership role with WHO and member states on
intersectoral action, reporting on cross-government
and cross-sectoral approaches to advance policy and
action on health inequalities, and also in engaging
other countries and WHO in an initiative to examine
the economic benefits of investing in the determinants
of health.
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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57
The Agency supported the work of the Canadian
Reference Group (CRG) to contribute to the WHO
Commission’s plan of work and to advance related
initiatives here in Canada. During 2006-07, the CRG
has initiated work on Canadian case studies of
effective intersectoral action, led the development of
case studies in 23 other countries, and engaged with
Civil Society on how to best address the social
determinants of health.
As a step towards the establishment of a Health
Portfolio Plan, the Agency developed a draft action
framework to outline its leadership role in advancing
federal action on the social determinants of health
and the beginning of an integrated approach within
the Health Portfolio. This work, when enhanced
through the knowledge to be gained from the WHO
Commission and Canadian Reference Group work,
will lead to further interdepartmental collaboration.
The Agency initiated working relationships and
knowledge sharing with other departments, private
sector partners and other levels of government
through its participation in the Conference Board of
Canada’s Roundtable on the Socio-Economic
Determinants of Health.
The Agency supported preparations for the World
Conference on Health Promotion and Education (to
be held in Vancouver in June 2007). During 2006-07,
the Agency coordinated the Health Portfolio’s lead
role in this event and organized sessions and speakers
to profile Canadian experiences with a global
audience and learn from other countries.
The Agency continued developing an international
strategic framework to support internationally focused
initiatives to strengthen public health security,
strengthen international efforts to build capacity in
public health systems, and reduce the global burdens
of disease and health disparity.
Other Programs and Services
Planned ($M)
Authorities ($M)
Actual ($M)
109.0
120.5*
119.0
* The $11.5 million difference between planned and authorities represents primarily operating budget carry forward received
in the Supplementary Estimates (A). The Agency was able to use of $11.0 million of this to address IM/IT infrastructure
requirements, comply with mandatory government-wide IT security policy, and respond to a computer malware infection.
Other Agency programs and services consisted primarily of corporate support and administration in the
National Capital Region, Winnipeg and the Agency’s
regional offices (Atlantic, Quebec, Ontario & Nunavut, Manitoba & Saskatchewan, Alberta & Northwest
Territories, British Columbia & Yukon). Under an interdepartmental agreement, Health Canada’s Northern
Region office was also responsible for administering
some of the Agency’s programs in Canada’s territories. Planned expenditures included $28.0 million for
the facility services and the support of the National
Microbiology Laboratory; $48.4 million for the corporate support in Human Resources, Communications,
Legal, Finance, Real Property and Administration
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PUBLIC HEALTH AGENCY OF CANADA
Services, Information Technology and Management;
$4.3 million for support in Strategic Policy and
Development and $17.9 million for regional support
operations across Canada. Planned funding also
included $10.4 million held in a frozen allotment
pending approval for a one-year extension.
Actual expenditures included $37.1 million for the
facility services and the support of the National
Microbiology Laboratory; $69.3 million for the corporate support in Human Resources, Communications,
Legal, Finance, Real Property and Administration
Services, Information Technology and Management;
and $11.1 million for regional support operations
across Canada.
Section III – SUPPLEMENTARY INFORMATION
Supplementary
Information
Section III
Table 1:
Comparison of Planned to Actual Spending
(including Full-Time Equivalents)
(in millions of dollars)
This table offers a comparison of the Main estimates, Planned Spending, Total Authorities and Actual Spending
for the recently completed fiscal year, as well as historical figures for Actual Spending.
2006–07
2004-05
Actual
2005-06
Actual
Main
Estimates
Planned
Spending
Total
Authorities
Total
Actuals
Population and Public Health
586.7
477.2
506.6
629.7
536.2
510.8
Total
586.7
477.2
506.6
**629.7**
***536.2***
****510.8****
0.0
0.2
0.0
0.0
0.0
0.3
11.4
17.6
0.0
20.2
20.2
21.0
Total Departmental
Spending
598.1
494.6
506.6
649.9
556.4
531.5
Full-time Equivalents
1,666
1,801
2,119
2,119
2,119
2,050
Less: Non-respendable
revenue
Plus: Cost of services
received without charge
* Full-time equivalents (FTE) are a measure of human resource consumption based on average levels of employment.
FTEs are not subject to Treasury Board control but are disclosed in Part III of the Estimates in support of personnel
expenditure requirements specified in the Estimates.
** The $123.1 million increase from Main Estimates to Planned Spending is due to increased funding for initiatives
announced in Federal budgets such as: Avian and Pandemic Influenza Preparedness ($66.3 million); Canadian
Strategy for Cancer Control ($52 million); Strengthening Canada’s Public Health Systems ($4.2 million); one year
extension for the Centre of Excellence for Children’s Well Being ($1.8 million); offset by savings in procurement
resulting from the ERC exercise ($1.2 million).
*** The $93.5 million decrease from Planned Spending to Total Authorities is mainly due to funding for Avian and
Pandemic Influenza Preparedness deferred to subsequent fiscal years ($44 million); and funding for Canadian
Strategy for Cancer Control provided to Health Canada instead of the Agency ($51 million).
**** The $25.4 million difference between Total Authorities and Actual Spending is mainly the result of lapses in operating
expenditure of $20.5 million and transfer payments of $4.9 million.
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PUBLIC HEALTH AGENCY OF CANADA
Table 2:
Resources by Program Activity
This table reflects how resources were used within the Public Health Agency of Canada by appropriation and by
program activity.
(in millions of dollars)
2006–07 Budgetary
Operating
Grants
Contributions
and other
Transfer
Payments
Main Estimates
327.4
33.1
146.2
506.7
(0.1)
506.6
Planned Spending
392.7
89.1
148.0
629.8
(0.1)
629.7
Total Authorities
349.3
22.6
164.4
536.3
(0.1)
536.2
Actual Spending
328.7
21.0
161.2
510.9
(0.1)
510.8
Total: Gross
Budgetary
Expenditures
Less:
Respendable
Revenue
Total: Net
Budgetary
Expenditures
Population and
Public Health
Table 3:
Voted and Statutory Items
(in millions of dollars)
2006–07
Vote or
Statutory Item
Truncated Vote
or Statutory Wording
Main
Estimates
Planned
Spending
Total
Authorities
Total Actuals
35
Operating expenditures
299.3
363.4
326.0
305.4
40
Grants and contributions
179.3
237.1
187.0
182.2
(S)
Contributions to employee benefit
plans
28.0
29.2
23.2
23.2
0.0
0.0
0.0
0.0
506.6
629.7
536.2
510.8
(S)
Spending of proceeds from the
disposal of surplus Crown assets
Actual = $1,286.81
Total
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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61
Table 4:
Services Received Without Charge
(in millions of dollars)
2006–07
Actual Spending
Accommodation provided by Public Works and Government Services Canada
Contributions covering the employer's share of employees' insurance premiums and expenditures paid
by the Treasury Board of Canada Secretariat.
Salary and associated expenditures of legal services provided by the Department of Justice Canada
Total 2006-07 Services received without charge
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PUBLIC HEALTH AGENCY OF CANADA
9.4
11.5
0.1
21.0
Table 5:
Sources of Respendable and Non-respendable Revenue
Respendable Revenue (in millions of dollars)
2006-07
Actual
2004-05
Actual
2005-06
Main
Estimates
Planned
Revenue
Total
Authorities
Actual
Sale to federal and provincial/
territorial departments and agencies,
airports and other federally regulated
organizations of first aid kits to be
used in disaster and emergency
situations
0.1
0.1
0.1
0.1
0.1
0.1
Spending of proceeds from the
disposal of surplus Crown assets
0.0
0.0
0.0
0.0
0.0
0.0
Total Respendable Revenue
0.1
0.1
0.1
0.1
0.1
0.1
Population and Public Health
Non-respendable Revenue (in millions of dollars)
2006-07
Actual
2004-05
Actual
2005-06
Main
Estimates
Planned
Revenue
Total
Authorities
Actual
Sale of first aid kits / net vote revenue
surplus
0.0
0.1
0.0
0.0
0.0
0.0
Royalties and other miscellaneous
revenues
0.0
0.0
0.0
0.0
0.0
0.1
Sundries – credit cards rebate
0.0
0.1
0.0
0.0
0.0
0.2
Total Non-respendable Revenue
0.0
0.2
0.0
0.0
0.0
0.3
Population and Public Health
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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63
Table 6:
Resource Requirements by Branch
(in millions of dollars)
Population and Public Health
Agency Executive, Chief Public Health Officer*
Planned Spending
8.8
Actual Spending
4.8
Infectious Disease and Emergency Preparedness Branch**
Planned Spending
219.1
Actual Spending
161.8
Health Promotion and Chronic Disease Prevention Branch***
Planned Spending
Actual Spending
153.7
81.9
Strategic Policy, Communications and Corporate Services Branch****
Planned Spending
64.5
Actual Spending
81.0
Public Health Practice and Regional Operations Branch
Planned Spending
183.6
Actual Spending
181.3
Agency Total
Planned Spending
629.7
Actual Spending
510.8
The major differences between Planned and Actual spending are:
* Agency Executive, Chief Public Health Officer: The $4.0 million lapse was due to capacity and technical constraints
in staffing coupled with deferment of Pandemic initiatives to future years.
** Infectious Disease and Emergency Preparedness Branch: Funding for Avian and Pandemic Influenza Preparedness
deferred to subsequent fiscal years of $44 million; and funding reallocated to other branches $6.6 million leaving a
small lapse of $6.7 million.
*** Health Promotion and Chronic Disease Prevention Branch: $51 million of funding for the Canadian Strategy for
Cancer Control was approved under Health Canada as opposed to the Agency as originally envisioned; $15.4
million was allocated to other branches for new unplanned priorities; $5.4 million lapsed due to delays and timing
changes; and uncertainty of funding by Governor General Special Warrants earlier in the fiscal year included the
need to cash manage close to $3 million to operate the Centre of Excellence for Children which was not funded.
**** Strategic Policy, Communications and Corporate Services Branch: Operating Budget carry forward from 2005-06
provided $11.7 million, and funding transferred from other branches provided $4.8 million to cover new emerging
pressures.
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PUBLIC HEALTH AGENCY OF CANADA
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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65
Other
products and
services (O)
Access to
Information
Act
1992
Date Last
Modified
See Section
C – Other
Information
Note 1
Forecast
Revenue
($000)
See Section
C – Other
Information
Note 1
Actual
Revenue
($000)
See Section
C – Other
Information
Note 1
Full Cost
($000)
Response provided
within 30 days
following receipt of
request: response
time may be
extended pursuant
to section 9 of the
ATIA. Notice of
extension to be sent
within 30 days of
receipt of request.
Performance
Standard
2006–07
See Section
C – Other
Information
Note 1
Performance
Results
0.7
0.8
0.9
2008-09
2009-10
Forecast
Revenue
($000)
2007-08
Fiscal
Year
Planning Years
580
580
580
Estimated
Full Cost
($000)
Information on Service Standards for External Fees can be found at: http://www.tbs-sct.gc.ca/est-pre/estime.asp.
Table 7B: Policy on Service Standards for External Fees
1. Access to Information requests filed for the Public Health Agency of Canada in 2006-07 were processed by Health Canada. Accordingly, associated revenues and costs are reported under Health
Canada for 2006-07.
C. Other Information
B. Date Last Modified
Fees charged for
the processing
of access
requests filed
under the
Access to
Information Act
(ATIA)
A. User Fee
Fee Type
Fee-setting
Authority
Table 7A: User Fees Act
Table 8:
Details on Transfer Payment Programs (TPPs)
The following is a summary of the transfer payment programs for the Agency that are in excess of $5 million. All
the transfer payments shown below are voted programs.
1. Population Health Fund
2. Community Action Program for Children
3. Canada Prenatal Nutrition Program
4. Federal Initiative to Address HIV/AIDS in Canada
5. Aboriginal Head Start in Urban and Northern Communities / Early Childhood Development
6. Canadian Health Network
7. Canadian Diabetes Strategy
8. National Collaborating Centres Contribution Program
Supplementary information on these Transfer Payment Programs can be found at http://www.tbs-sct.gc.ca/
est-pre/estime.asp.
Table 9:
Conditional Grants (Foundations)
n The Agency provided a one-time conditional grant of $100 million to Canada Health Infoway in 2004-05 to
support health surveillance.
Canada Health Infoway Inc. (Infoway) is an independent not-for-profit corporation with a mandate to foster and
accelerate the development and adoption of electronic health information systems and compatible standards
and communications technologies across Canada. Infoway is also a collaborative mechanism in which the
federal, provincial and territorial governments participate as equals, toward a common goal of modernizing
Canada’s health information systems. The Public Health Agency of Canada’s portion under this collaboration is
the Health Surveillance Program. Health Canada has provided the Supplementary Information on their and the
Public Health Agency of Canada’s conditional grants to Infoway.
Further information on this Conditional Grant can be found at: http://www.tbs-sct.gc.ca/est-pre/estime.asp.
66 |
PUBLIC HEALTH AGENCY OF CANADA
Table 10: Financial Statements
The following Financial Statements have been prepared in accordance with accrual accounting principles. The
information presented in the other financial tables of this Performance Report were prepared on a modified cash
basis of accounting in order to be consistent with appropriations-based reporting. Footnote 3 of the financial
statements reconciles these two accounting methods.
DEPARTMENTAL PERFORMANCE REPORT 2006–07
|
67
Statement of Operations (unaudited)
PUBLIC HEALTH AGENCY OF CANADA
For the year ended March 31
2007
2006
(in dollars)
Expenses
Salaries and employee benefits
183,791,847
170,341,797
Transfer payments
181,361,341
175,244,575
Professional and special services
70,287,779
55,138,587
Utilities, material and supplies
37,356,355
41,351,299
Travel and relocation
17,485,034
15,793,168
Accommodation
12,884,158
11,961,621
Purchased repair and maintenance
8,887,103
6,019,930
Information
8,623,347
4,599,372
Amortization of tangible capital assets
6,920,987
6,263,550
Communication
5,287,798
4,748,297
Rentals
1,428,167
1,307,661
Other
1,784,117
1,180,989
536,098,033
493,950,846
Rights and Privileges
28,377
25,376
Services of a Non-Regulatory Nature
88,871
125,742
Revenues
Sales of goods and services
Interest
Other
Net cost of operations
The accompanying notes form an integral part of the financial statements
68 |
PUBLIC HEALTH AGENCY OF CANADA
7,948
11,890
216,299
105,106
341,495
268,114
535,756,538
493,682,732
Statement of Financial Position (unaudited)
PUBLIC HEALTH AGENCY OF CANADA
At March 31
2007
2006
(in dollars)
Assets
Financial assets
Accounts receivable and advances (Note 4)
Total financial assets
8,067,818
5,884,928
8,067,818
5,884,928
63,517,725
65,742,171
63,517,725
65,742,171
71,585,543
71,627,099
94,035,266
79,975,372
8,432,076
7,387,369
28,512,678
24,109,715
2,763,581
2,402,497
133,743,602
113,874,953
(62,158,058)
(42,247,854)
71,585,543
71,627,099
Non-financial assets
Tangible capital assets (Note 5)
Total non-financial assets
TOTAL
Liabilities and Equity of Canada
Liabilities
Accounts payable and accrued liabilities
Vacation pay and compensatory leave
Employee severance benefits (Note 6)
Other liabilities
Equity of Canada
TOTAL
Contractual Obligations (Note 7)
The accompanying notes form an integral part of the financial statements
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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69
Statement of Equity (unaudited)
PUBLIC HEALTH AGENCY OF CANADA
For the year ended at March 31
2007
2006
(42,247,854)
(10,242,764)
(535,756,538)
(493,682,732)
510,812,401
477,166,397
(3,259,280)
(6,413,953)
(in dollars)
Equity of Canada, beginning of year
Net cost of operations
Current year appropriations used (Note 3)
Refund of previous year expenditures
Revenue not available for spending (Note 3)
Change in net position in the Consolidated Revenue Fund
(Note 3)
Services provided without charge by other government departments
Equity of Canada, end of year
The accompanying notes form an integral part of the financial statements
70 |
PUBLIC HEALTH AGENCY OF CANADA
(Note 8)
(296,270)
(193,247)
(10,828,711)
(26,481,555)
19,418,194
17,600,000
(62,158,058)
(42,247,854)
Statement of Cash Flow (unaudited)
PUBLIC HEALTH AGENCY OF CANADA
For the year ended March 31
2007
2006
(in dollars)
Operating activities
Net cost of operations
535,756,538
493,682,732
(6,920,987)
(6,263,550)
Non-cash items:
Amortization of tangible capital assets (Note 5)
Gain (loss) on disposal of tangible capital assets
Services provided without charge by other government departments (Note 8)
(14,112)
12,367
(19,418,194)
(17,600,000)
Variations in Statement of Financial Position:
Increase (decrease) in accounts receivable and advances
Increase (decrease) in accounts payable and accrued liabilities
Decrease (increase) in other liabilities
2,182,890
5,052,368
(14,059,894)
(31,934,371)
(361,084)
(397,025)
Decrease (increase) in vacation pay and compensatory leave
(1,044,707)
(763,019)
Decrease (increase) in employee severance benefits
(4,402,963)
(4,374,271)
491,717,487
437,415,231
(Note 5)
4,711,940
6,674,778
Proceeds on disposal of tangible capital assets
(1,287)
(12,367)
4,710,653
6,662,411
(496,428,140)
(444,077,642)
Cash used by operating activities
Capital investment activities
Acquisitions of tangible capital assets
Cash used by investment activities
Financing activities
Net cash provided by Government of Canada
The accompanying notes form an integral part of the financial statements
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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Notes to the Financial Statements (unaudited)
PUBLIC HEALTH AGENCY OF CANADA
1. Authority and Objectives
The Public Health Agency of Canada (PHAC) was created as a new agency by orders in council on September 24, 2004 in response to growing
concerns about the capacity of Canada's public health system to anticipate and respond effectively to public health threats. Its creation is the
result of wide consultation with the provinces, territories, stakeholders and Canadians. It also follows recommendations from leading public
health experts - including Dr. David Naylor's report, Learning from SARS: Renewal of Public Health in Canada, as well as other Canadian and
international reports - for clear federal leadership on issues concerning public health and improved collaboration within and between
jurisdictions. The Public Health Agency of Canada Act, assented to December 12, 2006, provides a statutory foundation for the new agency.
The agency is mandated to work in collaboration with its partners, to lead federal efforts and to mobilize pan-Canadian action in preventing
disease and injury, and to promote and protect national and international public health through the following:
D Anticipating, preparing for, responding to and recovering from threats to public health;
D Carrying out surveillance of, monitoring, researching, investigating and reporting on diseases, injuries, other preventable health risks and
their determinants, and the general state of public health in Canada and internationally;
D Using the best available evidence and tools to advise and support public health stakeholders nationally and internationally as they work
to enhance the health of their communities;
D Providing public health information, advice and leadership to Canadians and stakeholders; and
D Building and sustaining a public health network with stakeholders.
2. Summary of significant accounting policies
The financial statements have been prepared in accordance with Treasury Board accounting policies which are consistent with Canadian
generally accepted accounting principles for the public sector.
Significant accounting policies are as follows:
(a) Parliamentary appropriations
The agency is financed by the Government of Canada through Parliamentary appropriations. Appropriations provided to the agency do not
parallel financial reporting according to Canadian generally accepted accounting principles since appropriations are primarily based on cash
flow requirements. Consequently, items recognized in the statement of operations and the statement of financial position are not necessarily
the same as those provided through appropriations from Parliament. Note 3 provides a high-level reconciliation between the two bases of
reporting.
(b) Net Cash Provided by Government
The agency operates within the Consolidated Revenue Fund (CRF), which is administered by the Receiver General for Canada. All cash
received by the agency is deposited to the CRF and all cash disbursements made by the agency are paid from the CRF. The net cash
provided by Government is the difference between all cash receipts and all cash disbursements including transactions between departments
of the federal government.
72 |
PUBLIC HEALTH AGENCY OF CANADA
2. Summary of significant accounting policies (continued)
(c) Change in net position in the Consolidated Revenue Fund
The change in net position in the Consolidated Revenue Fund is the difference between the net cash provided by Government and
appropriations used in a year, excluding the amount of non respendable revenue recorded by the agency. It results from timing differences
between when a transaction affects appropriations and when it is processed through the CRF.
(d) Revenues
Revenues are accounted for in the period in which the underlying transaction or event occurred that gave rise to the revenues.
(e) Expenses
Expenses are recorded on an accrual basis:
D Grants are recognized in the year in which the conditions for payment are met. In the case of grants which do not form part of an existing
program, the expense is recognized when the Government announces a decision to make a non-recurring transfer, provided the enabling
legislation or authorization for payment receives parliamentary approval prior to the completion of the financial statements.
D Contributions are recognized in the year in which the recipient has met the eligibility criteria or fulfilled the terms of a contractual
transfer agreement.
D Vacation pay and compensatory leave are expensed as the benefits accrue to employees under their respective terms of employment.
D Services provided without charge by other government departments for accommodation, the employer's contribution to the health and
dental insurance plans and legal services are recorded as operating expenses at their estimated cost.
(f) Employee future benefits
i) Pension benefits: Eligible employees participate in the Public Service Pension Plan, a multiemployer plan administered by the
Government of Canada. The agency's contributions to the Plan are charged to expenses in the year incurred and represent the total
obligation to the Plan by the agency. Current legislation does not require the agency to make contributions for any actuarial deficiencies
of the Plan.
ii) Severance benefits: Employees are entitled to severance benefits under labour contracts or conditions of employment. These benefits are
accrued as employees render the services necessary to earn them. The obligation relating to the benefits earned by employees is
calculated using information derived from the results of the actuarially determined liability for employee severance benefits for the
Government as a whole.
(g) Accounts receivable
Accounts receivable are stated at amounts expected to be ultimately realized. They are mainly comprised of amounts to be recovered from other
government departments and the recovery is considered certain. As a result, no provision has been recorded as an offset against these amounts.
(h) Contingent liabilities
Contingent liabilities are potential liabilities which may become actual liabilities when one or more future events occur or fail to occur. To the
extent that the future event is likely to occur or fail to occur, and a reasonable estimate of the loss can be made, an estimated liability is accrued
and an expense recorded. If the likelihood is not determinable or an amount cannot be reasonably estimated, the contingency is disclosed in the
notes to the financial statements.
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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73
2. Summary of significant accounting policies (continued)
(i) Tangible Capital Assets
All tangible capital assets having an initial cost of $10,000 or more are recorded at their acquisition cost. The agency does not capitalize
intangibles, works of art and historical treasures that have cultural, aesthetic or historical value, assets located on Indian Reserves and museum
collections.
Amortization of tangible capital assets is done on a straight-line basis over the estimated useful life of the asset as follows:
Asset Class
Buildings
25 years
Works and infrastructure
25 years
Machinery and equipment
8-12 years
Computer equipment
3-5 years
Computer software
3 years
Other Equipment
10-12 years
Motor Vehicles
4-7 years
Other Vehicles
10 years
(j) Measurement uncertainty
The preparation of these financial statements in accordance with Treasury Board accounting policies which are consistent with Canadian
generally accepted accounting principles for the public sector requires management to make estimates and assumptions that affect the reported
amounts of assets, liabilities, revenues and expenses reported in the financial statements. At the time of preparation of these statements,
management believes the estimates and assumptions to be reasonable. The most significant items where estimates are used are the liability for
employee severance benefits and the useful life of tangible capital assets. Actual results could significantly differ from those estimated.
Management's estimates are reviewed periodically and, as adjustments become necessary, they are recorded in the financial statements in the
year they become known.
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PUBLIC HEALTH AGENCY OF CANADA
3. Parliamentary Appropriations
The agency receives most of its funding through annual Parliamentary appropriations. Items recognized in the statement of operations and the
statement of financial position in one year may be funded through Parliamentary appropriations in prior, current or future years. Accordingly,
the agency has different net cost of operations for the year on a government funding basis than on an accrual accounting basis. The
differences are reconciled in the following tables:
(a) Reconciliation of net cost of operations to current year appropriations used:
(in dollars)
2007
Net cost of operations
535,756,538
Adjustments for items affecting net cost of operations but not affecting appropriations:
Add (Less):
Amortization of tangible capital assets
Services provided without charge by other government departments
Revenues not available for spending
Refund/Adjustment of previous years expenses
Gain (loss) on disposal of tangible capital assets
Proceeds on disposal of tangible capital assets
Allowance for Contingent Liabilities
Vacation pay and compensatory leave
Decrease (increase) in severance benefits
Justice Canada legal fees
Other non appropriated amounts
Adjustments for items not affecting net cost of operations but affecting appropriations:
Add (Less):
Acquisitions of tangible capital assets
Current year appropriations used
2006
493,682,732
(6,920,987)
(6,263,550)
(19,418,194)
(17,600,000)
296,270
193,247
3,259,280
6,413,953
(14,112)
12,367
(1,287)
(12,367)
(350,000)
0
(1,044,707)
(763,019)
(4,402,963)
(4,374,270)
(1,022,689)
(808,786)
(36,688)
11,312
(29,656,077)
(23,191,113)
4,711,940
6,674,778
4,711,940
6,674,778
510,812,401
477,166,397
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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75
3. Parliamentary Appropriations (continued)
(b) Appropriations provided and used:
(in dollars)
Operating expenditures - Vote 35 (2006 Vote 30)
2006
2007
299,278,000
234,719,000
Supplementary Vote 35a
30,730,105
Supplementary Vote 35b
0
0
Governor General's Special Warrants
0
59,164,660
Grants and contributions - Vote 40 (2006 Vote 35)
179,306,000
0
164,009,000
Supplementary Vote 40a
6,018,366
0
Supplementary Vote 40b
0
0
Governor General's Special Warrants
0
645,000
Transfer from Treasury Board - Vote 5
293,605
15,415,000
Transfer from TB - Vote 10
(62,500)
0
Transfer from TB - Vote 15
(1,635,000)
0
Total Voted Parliamentary Appropriations
513,928,576
473,952,660
Lapsed appropriations:
(26,306,443)
(19,842,269)
Total Voted Parliamentary Appropriations Used
487,622,133
454,110,391
23,188,745
23,043,639
1,287
12,367
Contributions to employee benefit plans
Spending of proceeds from the disposal of surplus Crown assets
Collection Agency Fees
Current year appropriations used
236
0
510,812,401
477,166,397
(c) Reconciliation of net cash provided by Government to current year appropriations used:
(in dollars)
Net cash provided by Government
Revenue not available for spending
Refund/Adjustment of previous years expenses
2007
496,428,140
2006
444,077,642
296,270
193,247
3,259,280
6,413,953
Change in net position in the Consolidated Revenue Fund
Variation in accounts receivable and advances
(2,182,890)
(5,052,368)
Variation in accounts payables and accrued liabilities
13,709,894
31,934,371
Variation in other liabilities
Justice Canada legal fees
Other adjustments
Change in net position in the Consolidated Revenue Fund
Current year appropriations used
361,084
397,025
(1,022,689)
(808,786)
(36,688)
11,313
10,828,711
26,481,555
510,812,401
477,166,397
4. Accounts receivable and advances
(in dollars)
2006
6,667,560
4,724,495
Receivables from external parties
1,376,712
1,142,623
Employee advances
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2007
Receivables from other Federal Government departments and agencies
PUBLIC HEALTH AGENCY OF CANADA
23,546
17,810
8,067,818
5,884,928
5. Tangible capital assets
Cost
Opening
Balance
Acquisitions
Closing
balance
Disposals and
write offs
(in dollars)
Land
Buildings
Works and Infrastructure
Machinery and Equipment
Computer Equipment
Computer Software
Other Equipment
Motor Vehicles
Other Vehicles
Accumulated Amortization
604,137
0
0
604,137
71,681,239
60,000
0
71,741,239
564,425
0
0
564,425
35,725,663
3,838,279
(439,289)
39,124,653
3,074,332
2,957,453
116,879
0
896,107
145,954
0
1,042,061
1,749,379
550,828
0
2,300,207
129,190
0
0
129,190
84,253
0
0
84,253
114,391,846
4,711,940
(439,289)
118,664,497
Opening
Balance
Amorization
Closing
balance
Disposals and
write offs
(in dollars)
Buildings
Works and Infrastructure
Machinery and Equipment
Computer Equipment
Computer Software
Other Equipment
Motor Vehicles
Other Vehicles
Net Tangible Capital Assets
25,795,047
2,866,990
0
24,479
22,577
0
47,056
20,312,096
3,069,295
(423,890)
22,957,501
28,662,037
1,524,612
543,163
0
2,067,775
571,080
182,238
0
753,318
296,249
219,823
0
516,072
41,859
16,901
0
58,760
84,253
0
0
84,253
48,649,675
6,920,987
(423,890)
55,146,772
Opening
Balance
Closing
balance
(in dollars)
Land
Buildings
Works and Infrastructure
Machinery and Equipment
Computer Equipment
Computer Software
Other Equipment
Motor Vehicles
Other Vehicles
604,137
604,137
45,886,192
43,079,202
539,946
517,369
15,413,567
16,167,152
1,432,841
1,006,557
325,027
288,743
1,453,130
1,784,135
87,331
70,430
0
0
65,742,171
63,517,725
Amortization expense for the year ended March 31,2007 is $6,920,987 (2006: $6,263,550)
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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77
6. Employee benefits
(a) Pension benefits
The agency's employees participate in the Public Service Pension Plan, which is sponsored and administered by the Government of Canada.
Pension benefits accrue up to a maximum period of 35 years at a rate of 2 percent per year of pensionable service, times the average of the
best five consecutive years of earnings. The benefits are integrated with Canada/Québec Pension Plans benefits and they are indexed to
inflation.
Both the employees and the agency contribute to the cost of the Plan. The expense presented below represents approximately 2.2 times the
contributions by employees.
(in dollars)
2007
2006
Expense for the year
17,090,105
17,052,293
The agency's responsibility with regard to the Plan is limited to its contributions. Actuarial surpluses or deficiencies are recognized in the
financial statements of the Government of Canada, as the Plan's sponsor.
(b) Severance benefits
The agency provides severance benefits to its employees based on eligibility, years of service and final salary. These severance benefits are
not pre-funded. Benefits will be paid from future appropriations. Information about the severance benefits, measured as at March 31, is as
follows:
(in dollars)
2007
Accrued benefit obligation, beginning of year
2006
24,109,715
19,735,444
Expense for the year
5,019,311
5,268,011
Benefits paid during the year
(616,348)
28,512,678
Accrued benefit obligation, end of year
(893,740)
24,109,715
7. Contractual Obligations
The nature of the agency's activity results in multi-year contracts and obligations whereby the agency will be
committed to make some future payments when the services/goods are received. Contractual obligations that can
be reasonably estimated are as follows:
(in dollars)
Transfer payments
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2007
2008
2009
2010
25,800,000
4,700,000
50,650,000
4,750,000
PUBLIC HEALTH AGENCY OF CANADA
2011 and
thereafter
45,900,000
Total
131,800,000
8. Related party transactions
The agency is related as a result of common ownership to all Government of Canada departments, agencies, and Crown corporations. The
agency enters into transactions with these entities in the normal course of business and on normal trade terms. Also, during the year, the
agency received services which were obtained without charge from other Government departments as presented in part (a).
(a) Services provided without charge
During the year the agency received services without charge from other departments. These services without charge have been recognized
in the agency's Statement of Operations as follows:
(in dollars)
2007
2006
Accommodation
7,800,000
7,000,000
Employer's contribution to the health and dental insurance plans
11,547,800
10,600,000
Legal services
0
70,394
19,418,194
17,600,000
The Government has structured some of its administrative activities for efficiency and cost-effectiveness purposes so that one department
performs these on behalf of all without charge. The costs of these services, which include payroll and cheque issuance services provided by
Public Works and Government Services Canada, are not included as an expense in the agency's Statement of Operations.
(b) Payables and receivables outstanding at year-end with related parties:
(in dollars)
2007
2006
Accounts receivable with other government departments and agencies
6,667,560
4,724,495
Accounts payable to other government departments and agencies
6,555,838
5,484,462
9. Comparative information
Comparative figures have been reclassified to conform to the current year’s presentation.
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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79
Table 11: Response to Parliamentary Committees, and Audits
and Evaluations
Response to Parliamentary Committees
The Standing Committee on Health tabled a report on September 18, 2006 entitled, Even One is too Many:
A call for a comprehensive action plan for Fetal Alcohol Spectrum Disorder. The four recommendations in the
report focus on:
1) the development of a comprehensive federal and national FASD action plan;
2) addressing issues around leadership, coordination and implementation of an FASD plan;
3) improving data collection and incidence and prevalence reporting; and,
4) putting in place a mechanism for evaluating and reporting to Parliament on FASD activities. For more
details:
http://cmte.parl.gc.ca/cmte/CommitteePublication.aspx?COM=10481&Lang=1&SourceId=169974
On March 27, 2007, the Standing Committee on Health (HESA) tabled a report on childhood obesity,
entitled Healthy Weights for Healthy Kids. Calling childhood obesity an “epidemic”, HESA seeks immediate
federal action to halt and reverse the increasing number of overweight/obese children in Canada. The Report
recognizes that underlying determinants of health affect children and their parents and their ability to make
healthy choices.
HESA calls upon all stakeholders to collaborate on comprehensive, coordinated, multi-sectoral measures to
promote healthy weights for children through increased access to healthy food choices and quality physical
activity. Throughout the Report, HESA encourages the Government of Canada (GoC) to collaborate with First
Nations and Inuit people (FN/I) to prevent childhood obesity.
For more details:
http://cmte.parl.gc.ca/cmte/CommitteePublication.aspx?COM=10481&Lang=1&SourceId=199309
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PUBLIC HEALTH AGENCY OF CANADA
Response to the Auditor General including to the Commissioner of the Environment and
Sustainable Development (CESD)
The May 2006 status report of the Auditor General included one Chapter which referred to the Public Health
Agency of Canada. Chapter 6, Management of Voted Grants and Contributions. The objective of this audit
was to determine the extent to which the government has ensured effective government-wide management
and control of the spending of public money through grants and contributions. In terms of coverage for the
Agency, the Community Action Program for Children was audited. Overall, Canadian Heritage, SSHRC and
the Agency met the OAG audit criteria, and found their processes for assessing applicant’s eligibility to be
satisfactory. The OAG concluded that the Agency’s progress in terms of monitoring was satisfactory.
The February 2007 status report of the Auditor General included one Chapter implicating Health Canada
and the Public Health Agency of Canada. Chapter 1: Advertising and Public Opinion Research. The audit
looked at a sample of advertising and public opinion research campaigns to see whether the departments
administering them were exercising adequate management and control and whether changes made in
response to the 2003 audit recommendations were effective.
The OAG found that in all but one case the departments had obtained the necessary approval from Cabinet
before initiating the campaign. With the Public Health Agency of Canada pandemic influenza campaign,
there was no Cabinet decision for the campaign. The Agency explained that a proposal was not submitted for
PCO approval and that an advertising agency was hired to develop a campaign that would only be launched
in case of a pandemic. The Government Advertising Committee was informed of this and acknowledged this
course of action in the Committee’s records of proceedings. Due to the nature of the campaign, the OAG
was satisfied with the explanation provided by the department.
There was one recommendation: Departments should ensure that the required notification of planned
research is provided to PWGSC prior to contacting research firms. Agency management agrees with the
recommendation and the Agency’s processes have been amended to ensure that we comply with the
requirement.
External Audits (conducted by the Public Service Commission of Canada or the Office of the
Commissioner of Official Languages.)
There was no external audit performed by the Public Service Commission or the Commissioner of Official
Languages in 2006-07.
Internal Audits
While a number of projects were started, no Internal Audits were completed in 2006-07. The Agency’s Chief
Audit Executive was hired in December 2006 and most efforts in the last quarter of 2006-07 were devoted to
the infrastructure of the newly created Audit Services Division.
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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81
Evaluations
The following evaluations were completed in 2005-06:
n Aboriginal Head Start in Urban and Northern Communities
n Canadian Health Network
n Canadian Diabetes Strategy
n Centres of Excellence for Children’s Well-Being
Evaluations Completed in 2006-07:
n Hepatitis C Prevention, Support and Research Program
n National Health Surveillance Infostructure Initiative
The status of the remaining evaluation reports are as follows:
n Fetal Alcohol Spectrum Disorder – Scheduled for 2008-09
n Canadian Strategy for Cancer Control – Not an Agency program, cancer-related programs are included in
the Integrated Strategy for Health Living and Chronic Disease
n Canadian Breast Cancer Initiative – Community Capacity Building Initiative – Scheduled for 2008-09
n Bovine Spongiform Encephalopathy (BSE) – Completed. Health Canada was the lead department.
n Falls Prevention Initiative – No longer has program authority – ended in 2004.
n National Immunization Strategy – Scheduled for 2007-08
(Note: some evaluation reports’ due dates have changed from those planned in the 2006-07 Report on Plans
and Priorities)
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PUBLIC HEALTH AGENCY OF CANADA
Table 12: Sustainable Development Strategy
Topic
Departmental Input
1. What are the key
goals, objectives, and/
or long-term targets of
the SDS?
During 2006-07, the Agency was still contributing to the Health Canada
Sustainable Development Strategy 2004-2007. Health Canada will be reporting
on those goals and objectives. Under that Strategy, the Agency had one target,
which was completed in 2005-2006.
Also during 2006-07, as part of its planning process and to support the federal
government’s sustainable development (SD) initiative, the Agency developed and
tabled in Parliament two Sustainable Development Strategies: the first in August,
to meet legislative obligations; and the second, in December to offer a more
robust plan and to coordinate with some 30 other departments. During the
development of the SDS, the Agency assessed how best to further incorporate SD
principles and values into its policy and operations.
The following SDS goals were identified:
1. Incorporate SD considerations into the planning and implementation of
Agency activities
2. Ensure that the Agency conducts its operations in a sustainable manner.
3. Build capacity to implement Goals 1 and 2.
2. How do your key
goals, objectives, and/
or long-term targets
help achieve your
department’s strategic
outcomes?
The focus for 2006-07 was on exploring the link between sustainable
development and public health. The Agency’s SD Strategy 2007-2010 states
that SD cannot be achieved without a healthy population, and the health of the
population cannot be maintained without a healthy environment. The SD
Strategy, therefore, supports the Agency’s 2006-07 strategic outcome: ‘Healthier
population by promoting health and preventing disease and injury’.
The following objectives support the SDS goals:
1.1 Contribute to building healthy and sustainable communities
1.2 Improve the health status of Canadians by fostering preventive and
collaborative approaches to SD among the Agency and its partners
2.1 Maximize the use of green procurement
2.2 Minimize the generation of hazardous waste in Agency-occupied facilities
2.3 Increase resource efficiencies in the operations of Agency buildings
3.1 Develop knowledge, commitment and action to implement SD approaches
to health public policy
3.2 Develop and use the tools to support the achievement of Goal 1 and 2.
3.3. Establish management systems, roles and responsibilities, authorities and
accountabilities to support SDS.
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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83
Topic
Departmental Input
3. What were your targets
for the reporting
period?
The target for the reporting period was to meet the legislated requirement to
table an SDS within two years of the establishment of the Public Health Agency of
Canada. This target was met on August 16.
4. What is your progress
to date?
The focus for 2006-07 was on establishing targets for the Agency’s first SD
Strategy. In its full strategy, the Agency published 23 SD targets for the 20072010 reporting period.
5. What adjustments have
you made, if any?
Development of the Agency’s first Strategy involved analysis of past targets from
the former Population and Public Health Branch and of audit findings and
expectations provided by the Commissioner of the Environment and Sustainable
Development. The Agency’s second Strategy built upon the first Strategy by
presenting a more comprehensive set of targets and by providing a management
framework with performance indicators.
Table 13: Procurement and Contracting
Information on Procurement and Contracting can be found at http://www.tbs-sct.gc.ca/est-pre/estime.asp.
Table 14: Horizontal Initiatives
The Public Health Agency of Canada participates in the following horizontal initiatives:
1. Federal Initiative to address HIV/AIDS in Canada
2. Preparedness for Avian and Pandemic Influenza
Supplementary information on these horizontal initiatives can be found at http://www.tbs-sct.gc.ca/est-pre/
estime.asp.
Table 15: Travel Policies
Information on the Agency’s travel policies can be found at http://www.tbs-sct.gc.ca/est-pre/estime.asp.
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PUBLIC HEALTH AGENCY OF CANADA
Section IV – Other Items of Interest
Other Items
of Interest
Section IV
Organizational Chart
Public Health Agency of Canada
Chief Public Health Officer
Chief Financial Officer (CFO)
Senior Science Advisor
Chief Audit Executive (CAE)
Senior Assistant Deputy Minister
Planning and Public Health Integration
Assistant Deputy Minister
Infectious Disease and
Emergency Preparedness
Deputy Chief Public Health Officer
Deputy Chief Public Health Officer
Health Promotion and Chronic Disease Prevention
Public Health Practice
Executive Director
Director General
Corporate Secretariat
Strategic Policy
Director General
Director General
Human Resources
Communications
Director General
Director General
Information Management/
Information Technology
Regional Operations
Director General
Administrative Services
(including Accommodation,
Safety, Security, etc.)
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PUBLIC HEALTH AGENCY OF CANADA
Strategic Plan 2007-2012: Information, Knowledge, Action
The Agency developed its first ever Strategic Plan in 2006-07. The Strategic Plan will guide the Agency’s
directions over the next five years by establishing its policy and programming priorities, and defining the areas
where it needs to align its efforts and resources to support these priorities. Clear strategic directions and priorities
will provide the policy overlay to ensure that annual business plans are well-integrated, resources are aligned
accordingly, and the entire effort is supported by integrated human resources planning and clear accountabilities. The Plan also provides the foundation for the Agency to critically review all of its programs and make
decisions concerning rationalization, reallocation, adjustment and re-engineering, with a view to enhance the
management and effective delivery of the Agency’s programs.
In its Strategic Plan, the Agency has set out three objectives:
1. Anticipate and respond to the health needs of Canadians
In support of this strategic objective, the Agency will focus on a number of priorities that are critical to its
abilities to reduce health disparity and contribute to a stronger public health capacity. Central to this objective
will be the ability of the Agency to effectively fulfill its mandate, maintaining credibility and enhancing its
already strong reputation. The policy and program priorities in this section represent specific areas where the
Agency has made a clear decision to make significant headway over the next five years in addressing major
public health challenges, key determinants of health, health disparities among Aboriginal peoples, children,
and seniors, and gaps in public health capacity.
2. Ensure actions are supported by integrated information and knowledge functions
Programs and research in the Agency will be aligned to support the priorities identified under the first
objective. Key to the success of the alignment will be better linkages between the Agency’s information and
knowledge development functions and its actions.
3. Further develop the Agency’s dedicated, professional workforce by providing it with the tools and leadership it
needs and by ensuring a supportive culture.
To continue providing high quality public health programming, research and advice, the Agency needs to
ensure that the organization and its people have the necessary organizational, management and cultural
supports. The objective is about making sure that the Agency is well-positioned and equipped to address the
first two objectives. Simply put, it is about managing to deliver on priorities.
In meeting these objectives, the Agency will strive to reach new levels of engagement of its many partners,
including Health Canada and the rest of the Health Portfolio, other federal departments, the provinces and
territories, stakeholders, and non-governmental organizations. By working collaboratively to deliver on the
priorities outlined in the Strategic Plan, the Agency will be well-positioned to make an effective contribution to
achieving the unified vision of the Minister of Health and the Government of Canada of healthier Canadians
and communities in a healthier world.
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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Corporate Business Planning
In 2006-07, the Agency made progress with its initial Corporate Business Plan, an important initiative designed
to assist in moving forward the five-year Strategic Plan. The Agency’s program and support areas identified their
objectives, challenges, and strategies in developing the Agency’s initial business plan, and laid the foundation
for an effective annual business planning process.
In addition, an integrated human resources and business planning methodology was developed to aid the
Agency in addressing current and future human resource needs through review of the current workforce, forecasting work requirements and the use of gap analysis to assess the Agency’s capacity to deliver on plans and
priorities. The planning approach stimulated considerable analysis and strategic thinking within organizational
units inside the Agency. When the integrated business and human resources planning methodology was
developed the Agency was in an organizational review and restructuring phase, and was still in the process of
finalizing its five-year Strategic Plan. Generation of a cohesive and comprehensive integrated business and
human resources plan for the Agency is planned for 2007-08.
Human Resources Management
The Agency developed an infrastructure to support effective labour-management consultation and communication so that by the end of the 2006-07 it had two consultation fora for labour and employee issues: the
National Labour-Management Consultation Committee (NLMCC) and the Human Resources Labour Consultation Committee (HRLCC). The NLMCC met once in 2006-07 following its creation and the HRLCC also met to
discuss various matters and was able to address and advance several key issues.
Since the establishment of the two committees there was clear evidence of a change in management’s position
vis-à-vis consultation and communication with bargaining agents. In the past, managers had been hesitant to
consult with and inform bargaining agents on issues affecting their members. However, after committee
establishment, there was a steady transition towards transparency and openness, not only in dialogue, but also
in better acceptance of the bargaining agent’s involvement in decision-making and co-development of policies
and procedures.
The Agency made considerable progress in training managers on the new staffing regime established through
the Public Service Modernization Act as a requirement for delegation of staffing authorities. Subsequent to this
training an openness was seen on the part of managers to be more closely engaged in the appointment process,
to take greater accountability for staffing decisions, and to receive training and information on new trends and
approaches.
Also in connection with staffing, departmental policies developed to govern the application of the new Public
Service Employment Act in the Agency were reviewed for their applicability and effectiveness. As a consequence,
a policy related to acting appointments was introduced and related staffing policies were amended to maintain
internal consistency.
As part of building its internal capacity to meet its mandate, during 2006-07, a comprehensive review of the
human resources services provided by Health Canada under the Memorandum of Understanding between the
Agency and Health Canada was undertaken. This was the first review since the creation of the Public Health
Agency of Canada in September 2004 and included the National Capital Region, the Winnipeg pillar and the
regional offices across Canada. Its purpose was to ensure that the services provided made good business sense
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PUBLIC HEALTH AGENCY OF CANADA
for both organizations under the Health Portfolio in terms of effectiveness, accountability and cost efficiency. As a
result of this review, the Agency made further progress in establishing its own infrastructure to deliver human
resources services from within the Agency so that, by end of year, corporate human resources policies, labour
relations, and human resources planning became the sole responsibility of the Agency and were managed
independently of Health Canada.
Sustainable Development
The Auditor General of Canada has called for better leadership and management in relation to horizontal
issues. The Agency’s first comprehensive sustainable development (SD) strategy responds to federal leadership
on Sustainable Development matters by aligning its commitments with federal SD goals, objectives and
guidelines. Within SD Strategy 2007-2010, the Agency incorporates recommendations by the Commissioner of
the Environment and Sustainable Development for demonstrated progress in sustainable development and a
result-based approach to the management of sustainable development initiatives. In addition, the strategy
furthers the concept of horizontality by demonstrating the integration of economic, social and environmental
considerations within a public health context. In its sustainable development strategy, the Agency commits to
coordinating and collaborating with other departments such as Health Canada, Transport Canada’s Active
Transportation Initiatives and with the partners in the Northern Antibiotic Resistance Partnership.
Completion of the SD strategy contributed to the Agency’s risk management activities by identifying opportunities
for risk mitigation through sustainable development commitments.
Risk Communications Framework
The Strategic Risk Communications Framework and Handbook was launched by the Chief Public Health Officer,
and is a new and unique tool designed to enable the Agency to integrate strategic risk communications into
effective risk management.
The Framework and Handbook gives Agency employees involved in risk management and risk communications
a science-based process to support effective decision-making. It provides the essential tools and techniques
needed to enable us to plan and conduct effective risk communication as an integral component of good
decision-making with stakeholders and ultimately the Canadian public.
Work on the Framework and Handbook had been underway for three years. A pilot project was successfully
conducted at Health Canada in 2005 and subsequently the Agency’s Executive Committee approved the
Framework and its implementation at the Agency.
As the group responsible for promoting the Agency-wide adoption and implementation of strategic risk
communications, the Communications Directorate began providing support and guidance on how to apply the
Framework. Risk communications training began for communications, policy and program employees working
together on risk issues. Plans for full implementation through training and application were put in place with the
intention of integrating risk communications into the Agency approach to effective decision-making and
communications.
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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Centre for Excellence in Evaluation and Program Design
In 2006-07, the Agency’s Centre for Excellence in Evaluation and Program Design established an Agency
Evaluation Advisory Committee. The Committee has a chair at the Deputy Chief Public Health Officer level, and
is composed of five additional voting members. The Chief Audit Executive also participates as a non-voting
member. Members’ key responsibilities include reviewing and recommending evaluation reports for Chief Public
Health Officer (CPHO) approval, reviewing the accompanying management response and action plans and
recommending them for CPHO acceptance, overseeing the development and implementation of an Agency
evaluation policy, reviewing the effectiveness of the Agency’s evaluation function, and reviewing the Agency’s
risk-based evaluation plan and recommending it for CPHO approval. In 2006-07, the Committee reviewed five
Agency program evaluation reports and recommended them for approval by the Chief Public Health Officer and
subsequent submittal to the Treasury Board Secretariat.
The Centre for Excellence in Evaluation and Program Design also initiated significant development work on a
five-year risk based evaluation plan which is a requirement of the Treasury Board Secretariat. The evaluation
plan will also ensure Agency programs will be provided with appropriate levels of advice and guidance based on
the timing of their upcoming evaluations and the estimated level of risk associated with the program.
Economics and Social Science Services Group (ES)
Development Program
The implementation of the ES Development program continued. It is a career development and recruitment
program targeting the Agency’s ES workforce. The first external recruitment was completed and qualified
candidates were scheduled to start their ESDP placements in the new fiscal year.
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PUBLIC HEALTH AGENCY OF CANADA
New Program Activity Architecture for 2007-08
During 2005-06 the Agency had a single strategic outcome and a single program activity. An enhanced
Program Activity Architecture, to take effect during fiscal year 2007-08, was developed to reflect the Agency’s
responsibilities, and to enable a more detailed reporting on accomplishments and resource use. Plans to
develop additional components of the Agency’s Management Results and Reporting Structure were rescheduled
to align with a government-wide process to be completed during 2007-08.
CROSSWALK
2006-07
2007-08
Strategic Outcome
Healthier Population by
promoting health and preventing
disease and injury
Healthier Canadians and a stronger public
health capacity
Program Activity(ies)
Population and Public Health
Health Promotion
Disease Prevention and Control
Emergency Preparedness and Response
Strengthen Public Health Capacity
Program Management and Support
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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Program
Activities for
2007-08
Program Activity Descriptions
Health
promotion
In collaboration with partners, the Public Health Agency of Canada supports effective
actions to promote healthy living and address the key determinants of health and major risk
factors for chronic disease, by contributing to knowledge development, fostering
collaboration, and improving information exchange among sectors and across jurisdictions.
Disease
prevention
and control
In collaboration with its partners, the Agency leads federal efforts and mobilizes domestic
efforts to protect national and international public health. These include:
n monitoring, researching and reporting on diseases, injuries, health risks and the general
state of public health in Canada and internationally; and
n supporting development of knowledge; intersectoral and international collaboration; and
developing policies and programs to prevent, control and reduce the impact of disease
and injury
Emergency
Preparedness
and Response
The Public Health Agency of Canada provides a national focal point for anticipating,
preparing for, responding to and facilitating recovery from threats to public health, and/or
the public health complications of natural disasters or human caused emergencies. The
Agency applies the legislative and regulatory provisions of The Quarantine Act. It
collaborates with international partners to identify emerging disease outbreaks around the
globe. Providing leadership in identifying and addressing emerging threats to the health and
safety of Canadians through surveillance, risk analysis and risk management activities, the
Agency partners with Health Canada, other federal departments, the provinces and
territories, international organizations and the voluntary sector to identify, develop and
implement preparedness priorities. The Public Health Agency of Canada manages and
supports the development of health-related emergency response plans for natural and
human caused disasters including the National Influenza Response Plan. The Agency is
actively engaged in developing and sponsoring training in emergency preparedness, and
coordinates counter-terrorism preparations to respond to accidents or suspected terrorist
activities involving hazardous substances. The Agency is a leader on biosafety related issues.
It stands ready to provide emergency health and social services, and manages the National
Emergency Stockpile System with holdings ranging from trauma kits to complete 200 bed
emergency hospitals.
Strengthen
Public Health
Capacity
Working with national and international partners, the Agency develops and provides tools,
applications, practices, programs and understandings that support and develop the
capabilities of front-line public health practitioners across Canada. The Agency facilitates
and sustains networks with provinces, territories, and other partners and stakeholders to
achieve public health objectives. The Agency’s work improves public health practice,
increases cross-jurisdictional human resources capacity, contributes to effective knowledge
and information systems, and supports a public health law and policy system that evolves in
response to changes in public needs and expectations.
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PUBLIC HEALTH AGENCY OF CANADA
Abbreviations Used in This Report
Abbreviations
Meaning
AHSUNC
Aboriginal Head Start in Urban and Northern Communities program
APEC
Asia-Pacific Economic Cooperation
C. difficile
Clostridium difficile
CAREID
Canada-Asia Regional Emerging Infectious Diseases
CARMEN
Conjunto do Acciones para la Reduccion Multifactorial de las Enfermedades No
Tranmisibles (PAHO initiative)
CBCI
Canadian Breast Cancer Initiative
CBCRA
Canadian Breast Cancer Research Alliance
CCDPC
Centre for Chronic Disease Prevention and Control
CDCEG
Communicable Disease Control Expert Group
CDS
Canadian Diabetes Strategy
CEPR
Centre for Emergency Preparedness and Response (Agency sub unit)
CFLRI
Canadian Fitness and Lifestyle Research Institute
CFTC
Child Fitness Tax Credit
CHIRPP
Canadian Hospitals Injury Reporting and Prevention Program
CHN
Canadian Health Network
CHP
Centre for Health Promotion (Agency sub unit)
CIDA
Canadian International Development Agency
CIDPC
Centre for Infectious Disease Prevention and Control (Agency sub unit)
CIHI
Canadian Institute for Health Information
CINDI
Countrywide Integrated Non-communicable Disease Intervention
CIPARS
Canadian Integrated Program for Antimicrobial Resistance Surveillance
CNCD
Chronic Non-communicable Disease
CNISP
Canadian Nosocomial Infection Surveillance Program
CPAC
Canadian Partnership Against Cancer
CPHN
Canadian Public Health Network
CPHO
Chief Public Health Officer
CRG
Canadian Reference Group
CSCC
Canadian Strategy for Cancer Control
EOC
Emergency Operations Centre
EURO
Regional Office for WHO for Europe
FASD
Fetal Alcohol Spectrum Disorder
DEPARTMENTAL PERFORMANCE REPORT 2006–07
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93
Abbreviations
Meaning
GPHIN
Global Public Health Intelligence Network
HBSC
Health Behaviours of School-aged Children
HERT
Health Emergency Response Team
HLIG
Healthy Living Issue Group
HPV
Human Papillomavirus
IDEP
Infectious Disease and Emergency Preparedness Branch (Agency sub unit)
iPHIS
Integrated Public Health Information System
JCSH
Joint Consortium for School Health
LFZ
Laboratory for Foodborne Zoonoses (Agency sub unit)
NACI
National Advisory Committee on Immunization
NAS
National Antiviral Stockpile
NCC
National Collaborating Centres
NCD
Non-communicable Disease
NDSS
National Diabetes Surveillance System
NESP
National Enteric Surveillance Program
NESS
National Emergency Stockpile System
NGO
Non-governmental Organization
NML
National Microbiology Laboratory (Agency sub unit)
NVHO
Financial Assistance to National Voluntary Health Organizations
PACP
Physical Activity Contribution Program
PAHO
Pan-American Health Organization (Regional Offices for WHO for the Americas)
PHAC
Public Health Agency of Canada
PHMG
Public Health Map Generator
PHPRO
Public Health Practice and Regional Operations Branch (Agency sub unit during
2006-07)
PPS
Pandemic Preparedness Secretariat (Agency sub unit)
PSC
Public Safety Canada
SARS
Severe Acute Respiratory Syndrome
SDOH
Social Determinants of Health
STI
Sexually Transmitted Infection
TBS
Treasury Board of Canada Secretariat
TPSAD
Transfer Payment Services and Accountability Division (Agency sub unit)
WHO
World Health Organization
WNV
West Nile Virus
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PUBLIC HEALTH AGENCY OF CANADA